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General NPI Number Information
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NPI Number | 1902122617
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Entity Type | Organization
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Legal Business Name | MOYEEN KHALEELI M.D. INC
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Dates
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Enumeration Date | 04/20/2010
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Last Update Date | 10/07/2014
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Provider Practice Location Address
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Address Line | 4305 TORRANCE BLVD 409
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City | TORRANCE
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State | CA
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Zip | 90503-4409
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Country | US
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Telephone | 310-371-2110
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Fax | 310-371-6102
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Provider Business Mailing Address
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Address Line | 4305 TORRANCE BLVD 409
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City | TORRANCE
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State | CA
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Zip | 90503-4409
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Country | US
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Telephone | 310-371-2110
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Fax | 310-371-6102
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Authorized Official
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Title or Position | PRESIDENT
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Name | MOYEEN KHALEELI
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Credential | M.D.
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Telephone | 310-371-2110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A26266
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | A26266
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License Number State | CA
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