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NPI Code Detail

MEDICARE: SOAD A KHALIFA MD

MEDICARE:   SOAD A KHALIFA  MD
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
12084P0800XPsychiatry PhysicianA067501CA

General Provider Information

NPI Number : 1598856171
Entity Type Code : Individual
Provider Name (Legal Business Name) : SOAD A KHALIFA MD
Provider Business Mailing Address
First Line : 3605 HOSPITAL RD STE D
Second Line :
City : ATWATER
State : CA
Zip : 95301-5173
Country : US
Telephone Number : 559-225-6100
Fax Number :
Provider Business Practice Location Address
First Line : 3605 HOSPITAL RD STE D
Second Line :
City : ATWATER
State : CA
Zip : 95301-5173
Country : US
Telephone Number : 559-225-6100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2006
Last Update Date : 07/08/2007

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Directions to “ SOAD A KHALIFA MD” Practice Location

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