Provider Demographics
NPI:1366260135
Name:KHUSHALANI, NEHA
Entity type:Individual
Prefix:
First Name:NEHA
Middle Name:
Last Name:KHUSHALANI
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 1:3263 PEPPERTREE PT
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-1504
Mailing Address - Country:US
Mailing Address - Phone:909-247-0026
Mailing Address - Fax:
Practice Address - Street 1:3263 PEPPERTREE PT
Practice Address - Street 2:
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-1504
Practice Address - Country:US
Practice Address - Phone:909-247-0026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35856152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist