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General NPI Number Information
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NPI Number | 1740723949
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Entity Type | Individual
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Provider Name | KHALIL GAIEB PHARMD
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Gender | Male
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Dates
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Enumeration Date | 11/21/2016
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Last Update Date | 01/05/2021
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Provider Practice Location Address
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Address Line | 1201 E PLAZA BLVD
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City | NATIONAL CITY
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State | CA
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Zip | 91950-3609
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Country | US
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Telephone | 619-477-7114
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Fax |
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Provider Business Mailing Address
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Address Line | 1330 W MCNEESE ST APT 5213
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City | LAKE CHARLES
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State | LA
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Zip | 70605-4523
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Country | US
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Telephone | 562-912-0542
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PST.021837
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH80291
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License Number State | CA
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