Provider Demographics
NPI:1083230361
Name:KHAN, RABEEA (DPM)
Entity Type:Individual
Prefix:DR
First Name:RABEEA
Middle Name:
Last Name:KHAN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:RABEEA
Other - Middle Name:
Other - Last Name:ABBAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:20130 LAKE CHABOT RD STE 202
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-5340
Mailing Address - Country:US
Mailing Address - Phone:105-811-4845
Mailing Address - Fax:510-581-7779
Practice Address - Street 1:3031 W MARCH LN STE 310
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95219-6562
Practice Address - Country:US
Practice Address - Phone:209-472-0800
Practice Address - Fax:209-472-1203
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-22
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE5973213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty