Healthcare Provider Details

I. General information

NPI: 1982628228
Provider Name (Legal Business Name): EMAN SHOUKRI KAMEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 12/01/2021
Certification Date: 12/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1456 WESTERN AVE
GLENDALE CA
91201-1214
US

IV. Provider business mailing address

1456 WESTERN AVE
GLENDALE CA
91201-1214
US

V. Phone/Fax

Practice location:
  • Phone: 818-240-0907
  • Fax: 818-247-4887
Mailing address:
  • Phone: 818-240-0907
  • Fax: 818-247-4887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA81115
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: