Individual
FATMA KHAKOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
20103 LAKE CHABOT RD, CASTRO VALLEY, CA 94546-5305
(510) 727-3256
(510) 727-3107
Mailing address
325 DISTEL CIR, LOS ALTOS, CA 94022-1408
(510) 727-3256
(510) 727-3107
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
809623
CA
208M00000X
Hospitalist Physician
Primary
A106306
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100505420
—
NV
01
—
A106306
STATE LICENSE
CA
01
—
CC7755
BLUE CROSS BLUE SHIELD
—
Enumeration date
07/07/2005
Last updated
09/30/2019
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