Provider Demographics
NPI:1558438382
Name:KHAIRULLAH, FIRHANA ZAHID (DO)
Entity Type:Individual
Prefix:DR
First Name:FIRHANA
Middle Name:ZAHID
Last Name:KHAIRULLAH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3431 ROCKROSE DR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-2308
Mailing Address - Country:US
Mailing Address - Phone:909-510-1412
Mailing Address - Fax:
Practice Address - Street 1:8686 HAVEN AVE
Practice Address - Street 2:STE 200
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-9109
Practice Address - Country:US
Practice Address - Phone:909-706-3950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9087207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine