Provider Demographics
NPI:1033387279
Name:KHOURY, JAMAL ELIAS (DC)
Entity Type:Individual
Prefix:
First Name:JAMAL
Middle Name:ELIAS
Last Name:KHOURY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15336 DEVONSHIRE ST STE 3
Mailing Address - Street 2:
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91345-2761
Mailing Address - Country:US
Mailing Address - Phone:818-891-8900
Mailing Address - Fax:
Practice Address - Street 1:15336 DEVONSHIRE ST. STE 3
Practice Address - Street 2:
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345
Practice Address - Country:US
Practice Address - Phone:818-891-8900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC24446111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor