MEDICARE: DR. MAHER DAKROUB D.O.

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	207RH0003X	Hematology & Oncology Physician	5101022064	FL
2	207RH0003X	Hematology & Oncology Physician	19179	CA

General Provider Information

NPI Number	:	1427438928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAHER DAKROUB D.O.

Provider Business Mailing Address
First Line	:	18000 STUDEBAKER RD STE 800
Second Line	:
City	:	CERRITOS
State	:	CA
Zip	:	90703-2671
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2601 W ALAMEDA AVE STE 300
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91505-4814
Country	:	US
Telephone Number	:	818-563-6278
Fax Number	:

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

Provider Enumeration Date	:	06/01/2015
Last Update Date	:	01/25/2022

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