Provider Demographics
NPI:1043487762
Name:EL SAID, KHALED (MD)
Entity Type:Individual
Prefix:DR
First Name:KHALED
Middle Name:
Last Name:EL SAID
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:KHALED
Other - Middle Name:
Other - Last Name:EL SAID
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:11882 DE PALMA RD STE 2F-1
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92883-4008
Mailing Address - Country:US
Mailing Address - Phone:951-603-3335
Mailing Address - Fax:909-799-2008
Practice Address - Street 1:11882 DE PALMA RD STE 2F-1
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92883-4008
Practice Address - Country:US
Practice Address - Phone:951-603-3335
Practice Address - Fax:909-799-2008
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-12
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA103426207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA 161325OtherPTAN
CAFH087ZOtherPTAN :FH087Z
CAFH072AOtherPTAN
CA452398065OtherEIN
CA 161325OtherPTAN