Individual ProviderBushra Khan IslamDietitian, RegisteredDietary & Nutritional Service ProvidersPractice Address10535 Hospital Way, Mather, CA 95655-4200(916) 843-2832PECOS EnrollmentBased on the most recent information from CMS, provider Bushra Khan Islam does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1558884247Provider TypeIndividualFull NameIslam, Bushra KhanCredentialRDNGenderFemaleSole ProprietorNoEnumeration Date7/25/2017Last Updated7/21/2022Contact InformationPractice LocationPractice Address10535 Hospital Way, Mather, CA 95655-4200Phone(916) 843-2832FaxUnlisted FaxMailing LocationMailing Address10535 Hospital Way, Mather, CA 95655-4200Phone(916) 843-2832FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode133V00000XPrimaryDescriptionDietitian, RegisteredDietary & Nutritional Service ProvidersLicenseUnlisted Issuer