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NPI Code Detail

MEDICARE: KHALED KERIZ

MEDICARE: KHALED KERIZ
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
1106S00000XBehavior TechnicianRBT-16-19320CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1106S00000XOTHERCARBT

General Provider Information

NPI Number : 1881192078
Entity Type Code : Individual
Provider Name (Legal Business Name) : KHALED KERIZ
Provider Business Mailing Address
First Line : 16782 VON KARMAN AVE STE 11
Second Line :
City : IRVINE
State : CA
Zip : 92606-2417
Country : US
Telephone Number : 855-223-7123
Fax Number :
Provider Business Practice Location Address
First Line : 1295 CORONA POINTE CT STE 110
Second Line :
City : CORONA
State : CA
Zip : 92879-1703
Country : US
Telephone Number : 855-223-7123
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2018
Last Update Date : 09/28/2021

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Directions to “ KHALED KERIZ ” Practice Location

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