Healthcare Provider Details

I. General information

NPI: 1912297540
Provider Name (Legal Business Name): RICHA A KHAMBETE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2011
Last Update Date: 04/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 GRANT RD
MOUNTAIN VIEW CA
94040-3200
US

IV. Provider business mailing address

1235 SUSAN WAY
SUNNYVALE CA
94087-1557
US

V. Phone/Fax

Practice location:
  • Phone: 650-967-0184
  • Fax: 650-968-0488
Mailing address:
  • Phone: 408-318-8975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number59480
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17042
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: