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General NPI Number Information
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NPI Number | 1053543165
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Entity Type | Individual
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Provider Name | GAMIL FTEEH M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/23/2009
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Last Update Date | 06/28/2022
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Provider Practice Location Address
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Address Line | 250 E CAROLINE ST STE J
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City | SAN BERNARDINO
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State | CA
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Zip | 92408-3758
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Country | US
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Telephone | 909-835-1810
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Fax | 909-835-1780
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Provider Business Mailing Address
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Address Line | 393 E WALNUT ST
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City | PASADENA
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State | CA
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Zip | 91188-0001
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Country | US
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Telephone | 909-558-8242
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Fax | 909-558-0479
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0402X
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Taxonomy Name | Neurology with Special Qualifications in Child Neurology Physician
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License Number | A130028
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License Number State | CA
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