Provider Demographics
NPI:1891567376
Name:KHWAJA, SHAKEEL (PHARMD)
Entity Type:Individual
Prefix:
First Name:SHAKEEL
Middle Name:
Last Name:KHWAJA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 W ALONDRA BLVD
Mailing Address - Street 2:
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90220-3533
Mailing Address - Country:US
Mailing Address - Phone:310-631-8674
Mailing Address - Fax:310-631-8673
Practice Address - Street 1:1410 W ALONDRA BLVD
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90220-3533
Practice Address - Country:US
Practice Address - Phone:310-631-8674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA771631835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy