Healthcare Provider Details
I. General information
NPI: 1245401025
Provider Name (Legal Business Name): RANIA EL KHAWAM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/19/2008
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
501 S BUENA VISTA ST
BURBANK CA
91505-4809
US
IV. Provider business mailing address
4140 W 190TH ST
TORRANCE CA
90504-5513
US
V. Phone/Fax
- Phone: 818-847-6332
- Fax: 818-847-6339
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080N0001X |
| Taxonomy | Neonatal-Perinatal Medicine Physician |
| License Number | 265781 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080N0001X |
| Taxonomy | Neonatal-Perinatal Medicine Physician |
| License Number | C196787 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: