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General NPI Number Information
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NPI Number | 1164442000
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Entity Type | Individual
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Provider Name | MOHAMMAD R KHAYALI M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 395 N SAN JACINTO ST STE #A
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City | HEMET
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State | CA
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Zip | 92543-3109
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Country | US
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Telephone | 951-652-6564
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Fax | 951-765-9875
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Provider Business Mailing Address
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Address Line | 44273 FRENCH CIR
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City | HEMET
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State | CA
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Zip | 92544-6679
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Country | US
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Telephone | 951-927-7711
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Fax |
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | A29943
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License Number State | CA
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