MEDICARE: WAEL EID MD PC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207R00000X	Internal Medicine Physician
2	207RP1001X	Pulmonary Disease Physician
3	207RC0200X	Critical Care Medicine (Internal Medicine) Physician

General Provider Information

NPI Number	:	1306908470
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WAEL EID MD PC

Provider Business Mailing Address
First Line	:	1801 W OLYMPIC BLVD # 1220
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91199-0001
Country	:	US
Telephone Number	:	702-233-6694
Fax Number	:	702-233-0485

Provider Business Practice Location Address
First Line	:	653 N TOWN CENTER DR STE 202
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89144-0516
Country	:	US
Telephone Number	:	702-233-6694
Fax Number	:	702-233-0485

Authorized Official
Title or Position	:	PRESIDENT
Name	:	WAEL EID
Credential	:	MD
Telephone Number	:	702-233-6694

Provider Enumeration Date	:	12/15/2006
Last Update Date	:	08/05/2010

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