Provider Demographics
NPI:1316007230
Name:KHWARG, STEVEN G (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:G
Last Name:KHWARG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:STEVEN
Other - Middle Name:G
Other - Last Name:KHWARG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3400 WEST LOMITA BLVD
Mailing Address - Street 2:#200
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4980
Mailing Address - Country:US
Mailing Address - Phone:310-326-3503
Mailing Address - Fax:310-326-2266
Practice Address - Street 1:3400 LOMITA BLVD
Practice Address - Street 2:#200
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4909
Practice Address - Country:US
Practice Address - Phone:310-326-3503
Practice Address - Fax:310-326-2266
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG47726207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG47726Medicaid
CAG47726Medicaid
CAG47726AMedicare PIN
CAG47726AMedicare ID - Type Unspecified