Provider Demographics
NPI:1184613598
Name:USMANI, GHAZALA NAHEED (MD)
Entity type:Individual
Prefix:DR
First Name:GHAZALA
Middle Name:NAHEED
Last Name:USMANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25993 MAR VISTA CT
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95033-8026
Mailing Address - Country:US
Mailing Address - Phone:781-254-4109
Mailing Address - Fax:
Practice Address - Street 1:812 POLLARD RD STE 1
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-1420
Practice Address - Country:US
Practice Address - Phone:408-374-1212
Practice Address - Fax:408-374-4160
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA413442080P0207X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110061069AMedicaid