Basic Information
| Provider Information | |||||||||
| NPI: | 1841229655 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAMEL | ||||||||
| FirstName: | NAWAL | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 625 FAIR OAKS AVE STE 270 | ||||||||
| Address2: | |||||||||
| City: | SOUTH PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 910305801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6263462455 | ||||||||
| FaxNumber: | 6266393005 | ||||||||
| Practice Location | |||||||||
| Address1: | 1151 E WALNUT ST | ||||||||
| Address2: | |||||||||
| City: | ONTARIO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917616155 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9094670797 | ||||||||
| FaxNumber: | 8777788097 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/02/2006 | ||||||||
| LastUpdateDate: | 03/30/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | A34963 | CA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 00A349630 | 01 | CA | MEDI CAL | OTHER | P01796286-DU4034 | 01 | CA | RR MEDICARE | OTHER | P01453372-DV5277 | 01 | CA | RAILROAD MEDICARE | OTHER | P01284210/DS9933 | 01 | CA | RAILROAD MEDICARE | OTHER |