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General NPI Number Information
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NPI Number | 1417735507
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Entity Type | Individual
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Provider Name | HUMMA BASHIR KHAWAJA
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Gender | Female
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Dates
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Enumeration Date | 09/19/2023
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 20630 STEVENS CREEK BLVD
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City | CUPERTINO
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State | CA
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Zip | 95014-2120
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Country | US
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Telephone | 203-709-0236
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Fax |
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Provider Business Mailing Address
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Address Line | 959 STEWART DR APT 725
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City | SUNNYVALE
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State | CA
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Zip | 94085-4076
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 36115
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License Number State | CA
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