Provider Demographics
NPI:1275635492
Name:AL-KHOURY, LAMA (MD)
Entity Type:Individual
Prefix:DR
First Name:LAMA
Middle Name:
Last Name:AL-KHOURY
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 1:3390 UNIVERSITY AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92501-3315
Mailing Address - Country:US
Mailing Address - Phone:844-827-8000
Mailing Address - Fax:951-530-4782
Practice Address - Street 1:3390 UNIVERSITY AVE STE 100
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-3315
Practice Address - Country:US
Practice Address - Phone:844-827-8000
Practice Address - Fax:951-530-4782
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA762522084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ094462OtherBLUE CROSS ID #
CA90050380OtherPACIFICARE PROVIDER ID#
CA0693834Medicaid
CAZZZ094462OtherBLUE CROSS ID #
CA90050380OtherPACIFICARE PROVIDER ID#