Provider Demographics
NPI:1912297540
Name:KHAMBETE, RICHA A
Entity Type:Individual
Prefix:
First Name:RICHA
Middle Name:A
Last Name:KHAMBETE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1235 SUSAN WAY
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-1557
Mailing Address - Country:US
Mailing Address - Phone:408-318-8975
Mailing Address - Fax:
Practice Address - Street 1:1040 GRANT RD
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-3200
Practice Address - Country:US
Practice Address - Phone:650-967-0184
Practice Address - Fax:650-968-0488
Is Sole Proprietor?:No
Enumeration Date:2011-04-16
Last Update Date:2011-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59480183500000X
NV17042183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist