Healthcare Provider Details

I. General information

NPI: 1013932979
Provider Name (Legal Business Name): FLORENCE MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1557 E FLORENCE AVE
LOS ANGELES CA
90001-2551
US

IV. Provider business mailing address

1557 E FLORENCE AVE
LOS ANGELES CA
90001-2551
US

V. Phone/Fax

Practice location:
  • Phone: 323-584-1490
  • Fax:
Mailing address:
  • Phone: 323-584-1490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA56258
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA56354
License Number StateCA

VIII. Authorized Official

Name: DR. NAGY KHALIL
Title or Position: OWNER
Credential: M.D.
Phone: 323-584-1490