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NPI Code Detail

MEDICARE: REBECCA EL-KHOURY

MEDICARE:   REBECCA  EL-KHOURY
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
1122300000XDentist1002155WI
2122300000XDentistDDS104717CA

General Provider Information

NPI Number : 1902458680
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA EL-KHOURY
Provider Business Mailing Address
First Line : 8031 LINDA VISTA RD # 210
Second Line :
City : SAN DIEGO
State : CA
Zip : 92111-5110
Country : US
Telephone Number : 818-644-3677
Fax Number :
Provider Business Practice Location Address
First Line : 8031 LINDA VISTA RD STE 210
Second Line :
City : SAN DIEGO
State : CA
Zip : 92111-5110
Country : US
Telephone Number : 619-916-3110
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2019
Last Update Date : 08/23/2022

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Directions to “ REBECCA EL-KHOURY ” Practice Location

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