# SHAMSUDDIN KHWAJA M D INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699006650
- **Authorized official:** GLORIA SUPERNAW (BILLING CONTRACTING MGR)
- **Authorized official phone:** (559) 935-5491

## Contact information

- **Practice address:** 729 WEST MEDICAL CENTER DR W SUITE 223, CLOVIS, CA 93611-6885
- **Practice address phone:** (559) 449-9990
- **Practice address fax:** (559) 449-9991
- **Mailing address:** 729 WEST MEDICAL CENTER DR W SUITE 223, CLOVIS, CA 93611-6885
- **Mailing address phone:** (559) 449-9990
- **Mailing address fax:** (559) 449-9991

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | A859070 | CA | Yes |

## Other

- **Enumeration date:** 01/14/2010
- **Last updated:** 02/06/2020