Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 77383 | AZ |
Y | 111NI0900X | Internist | 77383 | AZ |
N | 207RH0002X | Hospice and Palliative Medicine | 41007 | AZ |
NPI | 1225242373 |
---|---|
Provider Name | Dr. Lila Ammouri |
First Address | Goodyear, AZ 85338-3007 |
Second Address | Goodyear, AZ 85338-3007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2007 |
Last Update Date | 24/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
372784 | (05) | AZ |
P00816020 | RAILROAD MEDICARE (01) | AZ |