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General NPI Number Information
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NPI Number | 1598506396
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Entity Type | Individual
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Provider Name | KHALIL SAKKA
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Gender | Male
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Dates
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Enumeration Date | 06/05/2024
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 65 S HOCKETT ST
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City | PORTERVILLE
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State | CA
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Zip | 93257-4728
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Country | US
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Telephone | 559-576-9750
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Fax |
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Provider Business Mailing Address
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Address Line | 1711 W HENDERSON AVE
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City | PORTERVILLE
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State | CA
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Zip | 93257-1588
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Country | US
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Telephone |
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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 | 109961
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License Number State | CA
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