Healthcare Provider Details

I. General information

NPI: 1437350980
Provider Name (Legal Business Name): NAGY F. KHALIL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 09/11/2025
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

PO BOX 1529
LOS ANGELES CA
90001-0529
US

V. Phone/Fax

Practice location:
  • Phone: 714-522-2001
  • Fax:
Mailing address:
  • Phone: 714-522-2001
  • 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 Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA56258
License Number StateCA

VIII. Authorized Official

Name: NAGY KHALIL
Title or Position: OWNER
Credential:
Phone: 714-522-2001