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General NPI Number Information
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NPI Number | 1164509139
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Entity Type | Organization
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Legal Business Name | FAYEGH VAKILI INC
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 08/26/2010
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Provider Practice Location Address
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Address Line | 4477 W 118TH ST SUITE 503
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City | HAWTHORNE
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State | CA
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Zip | 90250-2255
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Country | US
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Telephone | 310-644-9500
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Fax | 310-644-0877
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Provider Business Mailing Address
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Address Line | 4477 W 118TH ST SUITE 503
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City | HAWTHORNE
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State | CA
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Zip | 90250-2255
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Country | US
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Telephone | 310-644-9500
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Fax | 310-644-0877
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Authorized Official
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Title or Position | ORTHOPEDIC SURGERY
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Name | DR. FAYEGH VAKILI
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Credential | M.D.
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Telephone | 310-644-3500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A39870
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License Number State | CA
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