Khaled, Ebtesam

Khaled, Ebtesam is an sole proprietor health care provider with primary practice located at 17772 Beach Blvd , Huntington Beach CA 92647-6819. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Khaled, Ebtesam can be contacted via phone (909) 305-0714.

Contact Information

Primary practice address
17772 Beach Blvd Huntington Beach CA 92647-6819
Phone: (909) 305-0714
Fax: (909) 394-7415
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X A49538 California

Profile Details

NPI number 1649376971
LBN Legal business name Khaled, Ebtesam
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 15th, 2006
Last updated Jan 17th, 2017 - about 7 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 1649376971 NPPES
California MEDICAID 00A495382

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