Basic Information
Provider Information
NPI: 1720242704
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NAKHL
FirstName: FADI
MiddleName: E.
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 18000 STUDEBAKER RD STE 800
Address2:  
City: CERRITOS
State: CA
PostalCode: 907032671
CountryCode: US
TelephoneNumber: 5627353226
FaxNumber: 5628691281
Practice Location
Address1: 3628 E IMPERIAL HWY STE 401
Address2:  
City: LYNWOOD
State: CA
PostalCode: 902622646
CountryCode: US
TelephoneNumber: 3106674000
FaxNumber: 3106674010
Other Information
ProviderEnumerationDate: 07/18/2008
LastUpdateDate: 10/16/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/16/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0003XME114963FLN Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
207RH0003XC170297CAY Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

No ID Information.


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