Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | E4807 | CA |
N | 213ES0103X | Foot & Ankle Surgery | EL1636 | CA |
NPI | 1013177633 |
---|---|
Provider Name | Dr. Nidal Khaja |
First Address | Palos Verdes Peninsula, CA 90274-3876 |
Second Address | Gardena, CA 90247-4011 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2008 |
Last Update Date | 21/10/2021 |