Healthcare Provider Details

I. General information

NPI: 1942562293
Provider Name (Legal Business Name): AHMAD EL KHATIB
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2012
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9515 W CAMELBACK RD STE 118
PHOENIX AZ
85037-1365
US

IV. Provider business mailing address

9515 W CAMELBACK RD STE 118
PHOENIX AZ
85037-1365
US

V. Phone/Fax

Practice location:
  • Phone: 623-322-7856
  • Fax: 623-258-4072
Mailing address:
  • Phone: 623-322-7856
  • Fax: 623-208-6088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number72430
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number11336
License Number StateSD
# 3
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number72430
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number11336
License Number StateSD
# 5
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number72430
License Number StateAZ
# 6
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number72430
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: