Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301094837 | MI |
N | 111NI0900X | Internist | 4301094837 | MI |
N | 207RC0000X | Internist - Cardiovascular Disease | 142019 | CA |
N | 208000000X | Pediatrician | 4301094837 | MI |
N | 2080P0202X | Pediatric Cardiologist | 142019 | CA |
NPI | 1285865675 |
---|---|
Provider Name | Ahmed Kheiwa |
First Address | Loma Linda, CA 92354-2804 |
Second Address | Loma Linda, CA 92354 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2009 |
Last Update Date | 04/10/2018 |