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NPI Code Detail

MEDICARE: MUSTAFA ALKHASHAB

MEDICARE: MUSTAFA ALKHASHAB
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency
2172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1780538991
Entity Type Code : Individual
Provider Name (Legal Business Name) : MUSTAFA ALKHASHAB
Provider Business Mailing Address
First Line : 545 N BENJAMIN LN STE 185
Second Line :
City : BOISE
State : ID
Zip : 83704-9625
Country : US
Telephone Number : 208-322-1026
Fax Number :
Provider Business Practice Location Address
First Line : 545 N BENJAMIN LN STE 185
Second Line :
City : BOISE
State : ID
Zip : 83704-9625
Country : US
Telephone Number : 208-322-1026
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2026
Last Update Date : 02/24/2026

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Directions to “ MUSTAFA ALKHASHAB ” Practice Location

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