Khafaja, Issam N

Khafaja, Issam N is an individual health care provider with primary practice located at 777 Flower St Ste A, Glendale CA 91201-3000. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Khafaja, Issam N can be contacted via phone (818) 552-6230.

Contact Information

Primary practice address
777 Flower St Ste A Glendale CA 91201-3000
Fax: (818) 888-7018
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X A54280 California

Profile Details

NPI number 1528062874
LBN Legal business name Khafaja, Issam N
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2005
Last updated Nov 5th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528062874 NPPES
California MEDICAID 00A542800

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