Provider Demographics
NPI:1710365879
Name:KHOJA, ALIA MAHMOUD (MD)
Entity type:Individual
Prefix:DR
First Name:ALIA
Middle Name:MAHMOUD
Last Name:KHOJA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 MERCHANT ST FL 22
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-4333
Mailing Address - Country:US
Mailing Address - Phone:808-225-6282
Mailing Address - Fax:808-957-0670
Practice Address - Street 1:1100 WARD AVE STE 960
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1600
Practice Address - Country:US
Practice Address - Phone:808-532-2159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-11
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021038959207RG0300X
CT70362207RG0300X
HI23758207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine