Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 249924 | NY |
N | 111NI0900X | Internist | 249924 | NY |
N | 207R00000X | Internist | A109031 | CA |
N | 111NI0900X | Internist | A109031 | CA |
Y | 207RH0000X | Hematologist | A109031 | CA |
N | 207RH0003X | Hematology & Oncology | A109031 | CA |
NPI | 1376785006 |
---|---|
Provider Name | Dr. Samer Khaled |
First Address | Los Angeles, CA 90051-0185 |
Second Address | Duarte, CA 91010-3012 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2009 |
Last Update Date | 06/11/2020 |