Healthcare Provider Details

I. General information

NPI: 1699823021
Provider Name (Legal Business Name): KAMAL A BATNIJI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

361 HOSPITAL RD SUITE #329
NEWPORT BEACH CA
92663-3522
US

IV. Provider business mailing address

361 HOSPITAL RD SUITE #329
NEWPORT BEACH CA
92663-3522
US

V. Phone/Fax

Practice location:
  • Phone: 949-650-8882
  • Fax: 949-650-2293
Mailing address:
  • Phone: 949-650-8882
  • Fax: 949-650-2293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberA25477
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: