Healthcare Provider Details

I. General information

NPI: 1336500305
Provider Name (Legal Business Name): KAYAL MEDICAL GROUP INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2016
Last Update Date: 03/23/2023
Certification Date: 03/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 W SAN MARCOS BLVD STE 210
SAN MARCOS CA
92078-1147
US

IV. Provider business mailing address

PO BOX 511475
LOS ANGELES CA
90051-8030
US

V. Phone/Fax

Practice location:
  • Phone: 760-707-6765
  • Fax:
Mailing address:
  • Phone: 866-284-2771
  • Fax: 800-334-1041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ANAS KAYAL
Title or Position: PRESIDENT
Credential: MD
Phone: 408-324-6136