MEDICARE: DR. NAGY KHALIL M.D.

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

General Provider Information

NPI Number	:	1598784811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NAGY KHALIL M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1529
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90001-0529
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	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	07/08/2007

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