Healthcare Provider Details

I. General information

NPI: 1407200553
Provider Name (Legal Business Name): LUTFI TAUFIK AL-KHOUJA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2016
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 CITY BLVD W
ORANGE CA
92868-2903
US

IV. Provider business mailing address

333 CITY BLVD W
ORANGE CA
92868-2903
US

V. Phone/Fax

Practice location:
  • Phone: 714-456-5532
  • Fax:
Mailing address:
  • Phone: 714-456-5532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA151067
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: