Provider Demographics
NPI:1245598200
Name:KHALAF, DAREEN (MD)
Entity Type:Individual
Prefix:DR
First Name:DAREEN
Middle Name:
Last Name:KHALAF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1445 N LA BREA AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-7505
Mailing Address - Country:US
Mailing Address - Phone:323-798-5158
Mailing Address - Fax:
Practice Address - Street 1:1445 N LA BREA AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90028-7505
Practice Address - Country:US
Practice Address - Phone:323-798-5158
Practice Address - Fax:323-798-4914
Is Sole Proprietor?:No
Enumeration Date:2012-04-27
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA122011207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program