Healthcare Provider Details
I. General information
NPI: 1346110921
Provider Name (Legal Business Name): ADAM M. KHALIL MD P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/07/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7305 PACIFIC BLVD
HUNTINGTON PARK CA
90255-5736
US
IV. Provider business mailing address
16051 BALLANTINE LN
HUNTINGTON BEACH CA
92647-3201
US
V. Phone/Fax
- Phone: 323-585-6900
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ADAM
M
KHALIL
Title or Position: OWNER
Credential:
Phone: 720-839-2853