MEDICARE: KHALDOON RAMMO DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	57972	CA

General Provider Information

NPI Number	:	1275562340
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KHALDOON RAMMO DDS

Provider Business Mailing Address
First Line	:	18800 MAIN ST
Second Line	:	SUITE 205
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92648-1707
Country	:	US
Telephone Number	:	714-841-4954
Fax Number	:	714-841-4964

Provider Business Practice Location Address
First Line	:	18800 MAIN ST
Second Line	:	SUITE 205
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92648-1707
Country	:	US
Telephone Number	:	714-841-4954
Fax Number	:	714-841-4964

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2006
Last Update Date	:	05/20/2009

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