Provider Demographics
NPI:1033739180
Name:KHALID, UMAIR (MD)
Entity Type:Individual
Prefix:
First Name:UMAIR
Middle Name:
Last Name:KHALID
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 E SPRUCE AVE STE 431
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3330
Mailing Address - Country:US
Mailing Address - Phone:559-450-7449
Mailing Address - Fax:559-450-7470
Practice Address - Street 1:2006 SHAW AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-4192
Practice Address - Country:US
Practice Address - Phone:559-450-5880
Practice Address - Fax:559-450-5881
Is Sole Proprietor?:No
Enumeration Date:2020-04-19
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA185393207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program