Provider Demographics
NPI:1538460308
Name:GHADIR KINAWY M D INC
Entity Type:Organization
Organization Name:GHADIR KINAWY M D INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GHADIR
Authorized Official - Middle Name:M
Authorized Official - Last Name:KINAWY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-547-9090
Mailing Address - Street 1:1125 E 17TH ST
Mailing Address - Street 2:SUITE W-122
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-2201
Mailing Address - Country:US
Mailing Address - Phone:714-547-9090
Mailing Address - Fax:714-547-5005
Practice Address - Street 1:1125 E 17TH ST
Practice Address - Street 2:SUITE W-122
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-2201
Practice Address - Country:US
Practice Address - Phone:714-547-9090
Practice Address - Fax:714-547-5005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-10
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA64905208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H61057Medicare UPIN