Provider Demographics
NPI:1437188380
Name:KILANI, MARWA W (MD)
Entity Type:Individual
Prefix:DR
First Name:MARWA
Middle Name:W
Last Name:KILANI
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 1:21539 ARCOS DR
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-4304
Mailing Address - Country:US
Mailing Address - Phone:818-293-8199
Mailing Address - Fax:
Practice Address - Street 1:21539 ARCOS DR
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-4304
Practice Address - Country:US
Practice Address - Phone:818-293-8199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-02
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA77118207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA77118OtherSTATE LICENSE