Provider Demographics
NPI:1528893468
Name:KHAN, MOHAMMAD RAZZA (RPH)
Entity type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:RAZZA
Last Name:KHAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 ORO DAM BLVD E
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95965-5722
Mailing Address - Country:US
Mailing Address - Phone:530-534-1554
Mailing Address - Fax:
Practice Address - Street 1:850 ORO DAM BLVD E
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95965-5722
Practice Address - Country:US
Practice Address - Phone:530-534-1554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-02
Last Update Date:2024-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA88288183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist