Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | A062789 | CA |
NPI | 1003824673 |
---|---|
Provider Name | Hosayn Khaleeli |
First Address | Torrance, CA 90501-5302 |
Second Address | Torrance, CA 90501-5302 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 07/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A627890 | (05) | CA |
H58089 | (02) |