Provider Demographics
NPI:1548291156
Name:KHALID, YASMEEN (MD)
Entity type:Individual
Prefix:DR
First Name:YASMEEN
Middle Name:
Last Name:KHALID
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 E ALMOND AVE
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93637-6500
Mailing Address - Country:US
Mailing Address - Phone:559-675-5006
Mailing Address - Fax:559-675-5134
Practice Address - Street 1:1260 E ALMOND AVE
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93637-6500
Practice Address - Country:US
Practice Address - Phone:559-675-5006
Practice Address - Fax:559-675-5134
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA62895207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A628950Medicaid
G79048Medicare UPIN
CA00A628950Medicare ID - Type Unspecified