Provider Demographics
NPI:1285656835
Name:MORCOS, NABIL CHARLE (MD, PHD)
Entity Type:Individual
Prefix:
First Name:NABIL
Middle Name:CHARLE
Last Name:MORCOS
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:N.
Other - Middle Name:CHARLE
Other - Last Name:MORCOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:999 N TUSTIN AVE SUITE 112
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3528
Mailing Address - Country:US
Mailing Address - Phone:714-564-8287
Mailing Address - Fax:714-564-0014
Practice Address - Street 1:999 N TUSTIN AVE SUITE 112
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3528
Practice Address - Country:US
Practice Address - Phone:714-564-8287
Practice Address - Fax:714-564-0014
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG74210207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G742100Medicaid
CAG74210Medicare ID - Type Unspecified
CA00G742100Medicaid