Individual
ALISA KHOMUTOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1924 ALCOA HWY, KNOXVILLE, TN 37920-1511
(818) 523-6550
Mailing address
7924 WOODMAN AVE UNIT 12, PANORAMA CITY, CA 91402-6225
(818) 212-9962
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
73554
TN
Other
Enumeration date
03/25/2020
Last updated
08/08/2025
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