Provider Demographics
NPI:1093746836
Name:GHOBRIAL-SEDKY, KARIM WAGUIH (MD)
Entity Type:Individual
Prefix:DR
First Name:KARIM
Middle Name:WAGUIH
Last Name:GHOBRIAL-SEDKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:823 GATEWAY CENTER WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92102-4541
Mailing Address - Country:US
Mailing Address - Phone:619-515-2300
Mailing Address - Fax:
Practice Address - Street 1:7290 EL CAJON BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92115-1829
Practice Address - Country:US
Practice Address - Phone:619-906-5347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA093426002084P0800X
CAA1192012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY30608012Medicaid
I39337Medicare UPIN
0390515Medicare ID - Type Unspecified
0509215Medicare ID - Type Unspecified
0690617Medicare ID - Type Unspecified
KY30608012Medicaid
0509312Medicare ID - Type Unspecified