MEDICARE: AYMAN KAMAL EL RAHEB DDS

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	1223G0001X	General Practice Dentistry	46054	CA

General Provider Information

NPI Number	:	1184815268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AYMAN KAMAL EL RAHEB DDS

Provider Business Mailing Address
First Line	:	68860 RAMON RD STE 1
Second Line	:
City	:	CATHEDRAL CTY
State	:	CA
Zip	:	92234-3385
Country	:	US
Telephone Number	:	760-324-1618
Fax Number	:	760-328-0293

Provider Business Practice Location Address
First Line	:	68860 RAMON RD STE 1
Second Line	:
City	:	CATHEDRAL CTY
State	:	CA
Zip	:	92234-3385
Country	:	US
Telephone Number	:	760-324-1618
Fax Number	:	760-328-0293

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2007
Last Update Date	:	04/11/2022

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