| Doctor Name: | DR. NIDAL KHAJA |
| NPI Number: | 1013177633 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | D.P.M. |
| License Number: | EL1636 |
| Business Practice Address: | 1246 W 155th St Gardena, CA - 902474011 |
| Business Phone Number: | 3107682256 |
| Business Fax Number: | 3103230914 |
| Mailing Address: | 955 Deep Valley Dr, # 4055 PALOS VERDES PENINSULA |
| State: | CA |
| Postal Code: | 902743876 |
| Phone Number: | 3105381110 |
| Fax Number: | 3105380929 |
| NPI Enumeration Date: | 06/17/2008 |
| NPI Last Update Date: | 11/21/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | EL1636 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |