Provider Demographics
NPI:1427385681
Name:KHC GROUP PC
Entity Type:Organization
Organization Name:KHC GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BILAL
Authorized Official - Middle Name:R
Authorized Official - Last Name:KAAKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-637-3350
Mailing Address - Street 1:5419 HOLLYWOOD BLVD
Mailing Address - Street 2:C751
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-3480
Mailing Address - Country:US
Mailing Address - Phone:301-637-3350
Mailing Address - Fax:301-576-5221
Practice Address - Street 1:45 THOMAS JOHNSON DR
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4425
Practice Address - Country:US
Practice Address - Phone:301-637-3350
Practice Address - Fax:301-576-5221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-09
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21D1034190291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory