Organization Name: | MEDICAL GROUP OF PARAMOUNT, INC. |
NPI Number: | 1972563617 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | NABIL HORACIO KHOURY (PRESIDENT-MEDICAL DIRECTOR) |
Mailing Address: | 14906 Paramount Blvd Paramount |
State: | CA US |
Postal Code: | 907233409 |
Phone Number: | 5626301991 |
Fax Number: | 5626300145 |
NPI Enumeration Date: | 03/25/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A31583 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |