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General NPI Number Information
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NPI Number | 1174666796
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Entity Type | Individual
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Provider Name | DR. VICTOR KHALIL
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Gender | Male
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 12/10/2007
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Provider Practice Location Address
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Address Line | 19005 WILEYS WELL RD
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City | BLYTHE
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State | CA
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Zip | 92225-2287
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Country | US
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Telephone | 760-921-7548
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4461
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City | PALOS VERDES ESTATES
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State | CA
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Zip | 90274-9597
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Country | US
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Telephone | 310-849-0215
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 47107
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License Number State | CA
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