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General NPI Number Information
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NPI Number | 1669909941
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Entity Type | Organization
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Legal Business Name | PHILIP G KHOURY DO INC
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Dates
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Enumeration Date | 05/17/2017
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Last Update Date | 10/22/2018
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Provider Practice Location Address
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Address Line | 3850 RIVERLAKES DR STE B
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City | BAKERSFIELD
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State | CA
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Zip | 93312-6662
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Country | US
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Telephone | 661-241-9330
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Fax | 661-402-3540
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Provider Business Mailing Address
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Address Line | 3850 RIVERLAKES DR STE B
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City | BAKERSFIELD
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State | CA
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Zip | 93312-6662
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Country | US
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Telephone | 666-241-9330
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Fax | 666-402-3540
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Authorized Official
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Title or Position | CEO
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Name | PHILIP KHOURY
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Credential | DO
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Telephone | 661-241-9330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 20A14690
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License Number State | CA
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