=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811938541
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KAMEL LOUIS KAMEL M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/10/2006
-----------------------------------------------------
Last Update Date | 11/09/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4199 CAMPUS DR #550
-----------------------------------------------------
City | IRVINE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92612-4684
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-296-3440
-----------------------------------------------------
Fax | 949-679-2047
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5325 ALTON PKWY SUITE C # 619
-----------------------------------------------------
City | IRVINE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92604-3717
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-296-3440
-----------------------------------------------------
Fax | 949-653-0886
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | A48118
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------