Provider Demographics
NPI:1801395918
Name:KHALIFA, ABUBAKR M (RCP)
Entity Type:Individual
Prefix:MR
First Name:ABUBAKR
Middle Name:M
Last Name:KHALIFA
Suffix:
Gender:M
Credentials:RCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 W AVENUE K10
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536-5071
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4600 W AVENUE K10
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93536-5071
Practice Address - Country:US
Practice Address - Phone:661-435-7128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-04
Last Update Date:2018-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA267742278P3900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278P3900XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedNeonatal/Pediatrics