Provider Demographics
NPI:1154676146
Name:KHALAF, ROSSA (MD)
Entity Type:Individual
Prefix:
First Name:ROSSA
Middle Name:
Last Name:KHALAF
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 1:3945 E PARADISE FALLS DR STE 201
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-6687
Mailing Address - Country:US
Mailing Address - Phone:520-689-7022
Mailing Address - Fax:520-230-3310
Practice Address - Street 1:121 W ESPERANZA BLVD # 181
Practice Address - Street 2:
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-2622
Practice Address - Country:US
Practice Address - Phone:520-689-6992
Practice Address - Fax:520-230-3310
Is Sole Proprietor?:No
Enumeration Date:2012-07-17
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR5753207RX0202X
AZ65376207RX0202X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology