Healthcare Provider Details

I. General information

NPI: 1699102624
Provider Name (Legal Business Name): SAIRA ABID KHOKHAR PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2013
Last Update Date: 10/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9615 E OLD SPANISH TRL
TUCSON AZ
85748-7540
US

IV. Provider business mailing address

1662 W JUPITER WAY
CHANDLER AZ
85224-6437
US

V. Phone/Fax

Practice location:
  • Phone: 520-296-3775
  • Fax:
Mailing address:
  • Phone: 602-689-4609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS020185
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: