Provider Demographics
NPI:1376705459
Name:KHANNA, MEETA
Entity Type:Individual
Prefix:MS
First Name:MEETA
Middle Name:
Last Name:KHANNA
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:MEETA
Other - Middle Name:
Other - Last Name:KAPOOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5406 ONTARIO CMN
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94555-2927
Mailing Address - Country:US
Mailing Address - Phone:510-794-5310
Mailing Address - Fax:
Practice Address - Street 1:5406 ONTARIO CMN
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94555-2927
Practice Address - Country:US
Practice Address - Phone:510-794-5310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program