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General NPI Number Information
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NPI Number | 1194855486
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Entity Type | Organization
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Legal Business Name | PRIMARY CARE SPECIALISTS, INC
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 08/17/2010
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Provider Practice Location Address
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Address Line | 9131 ADAMS AVE
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92646-3403
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Country | US
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Telephone | 714-968-7800
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Fax |
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Provider Business Mailing Address
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Address Line | 9131 ADAMS AVE
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92646-3403
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Country | US
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Telephone | 714-968-7800
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. MICHAEL M KHATIBI
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Credential | MD
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Telephone | 714-968-7800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | FNP21643
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License Number State | CA
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