Individual provider Active NPI

Amal Elkhouli, MD

  • Phlebotomy Technician
  • Simi Valley, CA
National Provider Identifier
1497516090
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebotomy TechnicianTaxonomy code 246RP1900X
License
CPT-02228155 Issued in CA
Practice address
5490 Mohave Drive
Simi Valley, CA 93063-2012
Phone
(805) 304-5400
NPI assigned
Jan 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebotomy Technician 246RP1900X CPT-02228155 CA Primary

Addresses

Primary practice location

5490 Mohave Drive
Simi Valley, CA 93063-2012

Mailing address

5490 Mohave Drive
Simi Valley, CA 93063-2012
Phone (805) 304-5400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
CPT-02228155CAMDPhlebotomy Technician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1705622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1497516090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5490 MOHAVE DRIVE",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930632012",
            "telephone_number": "805-304-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5490 MOHAVE DRIVE",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930632012",
            "telephone_number": "805-304-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELKHOULI",
        "first_name": "AMAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-19",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "CA",
            "license": "CPT-02228155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.