MEDICARE: FLORENCE MEDICAL CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	A56258	CA
2	208000000X	Pediatrics Physician	A56354	CA

General Provider Information

NPI Number	:	1013932979
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORENCE MEDICAL CENTER

Provider Business Mailing Address
First Line	:	1557 E FLORENCE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90001-2551
Country	:	US
Telephone Number	:	323-584-1490
Fax Number	:

Provider Business Practice Location Address
First Line	:	1557 E FLORENCE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90001-2551
Country	:	US
Telephone Number	:	323-584-1490
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. NAGY KHALIL
Credential	:	M.D.
Telephone Number	:	323-584-1490

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	08/22/2020

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Directions to “FLORENCE MEDICAL CENTER ” Practice Location

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