Healthcare Provider Details

I. General information

NPI: 1972563617
Provider Name (Legal Business Name): MEDICAL GROUP OF PARAMOUNT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14906 PARAMOUNT BLVD
PARAMOUNT CA
90723-3409
US

IV. Provider business mailing address

14906 PARAMOUNT BLVD
PARAMOUNT CA
90723-3409
US

V. Phone/Fax

Practice location:
  • Phone: 562-630-1991
  • Fax: 562-630-0145
Mailing address:
  • Phone: 562-630-1991
  • Fax: 562-630-0145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA88689
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA37605
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA31583
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA 15959
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA 18278
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP 8951
License Number StateCA

VIII. Authorized Official

Name: DR. NABIL HORACIO KHOURY
Title or Position: PRESIDENT-MEDICAL DIRECTOR
Credential: M.D.
Phone: 562-630-1991