Amir Abu-Khalil, M.D.
Individual provider Active NPI Surgery Physician · Los Angeles, CA
NPI 1992095533 · NPPES record last updated Apr 16, 2011
Key facts
- NPI
- 1992095533
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgery Physician 208600000X
- License
- 208D00000X (CA)
- Practice address
- 10833 Le Conte Ave
72-235 CHS
Los Angeles, CA 90095-1749 - Phone
- (310) 825-6643
- NPI assigned
- Apr 16, 2011
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160708001626 | CA | Order and Referring Only - General Surgery |
4082906219 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 208D00000X | CA | MD | General Practice Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 208D00000X | CA | Yes |
Addresses
Primary practice location
10833 Le Conte Ave
72-235 CHS
Los Angeles, CA 90095-1749
Mailing address
3146 S Bentley Ave
Los Angeles, CA 90034-3008
Phone (310) 850-4846
Other providers in Los Angeles, CA
- Hengameh Abtahi
- Seyed Mahdi Abtahi
- Fereidoun G Abtin
- Katayoun Abtin
- Joseph Abu-Dalu
- Reem Ali Abu-Libdeh
- Rachel Abucasis
- Kathleen Mae Delos Reyes Abueva
- Ahmed Y. M. Abuhamad
- Marwa B Abulhasan
All providers in Los Angeles, CA · Surgery Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 16, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.