Provider Demographics
NPI:1982642526
Name:KHAJA, MASI (MD)
Entity Type:Individual
Prefix:
First Name:MASI
Middle Name:
Last Name:KHAJA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2460 PATTERSON RD UNIT 4
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81505-1027
Mailing Address - Country:US
Mailing Address - Phone:970-245-0990
Mailing Address - Fax:970-644-6446
Practice Address - Street 1:2460 PATTERSON RD UNIT 4
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505-1027
Practice Address - Country:US
Practice Address - Phone:970-245-0990
Practice Address - Fax:970-644-6446
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR44639207RG0100X
TXQ0950207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1982642526Medicaid
CO1982642526Medicaid