Provider Demographics
NPI:1609833631
Name:KHILFEH, YASER (MD)
Entity Type:Individual
Prefix:
First Name:YASER
Middle Name:
Last Name:KHILFEH
Suffix:
Gender:M
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:PO BOX 11600
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92685-1600
Mailing Address - Country:US
Mailing Address - Phone:562-809-3541
Mailing Address - Fax:562-468-0347
Practice Address - Street 1:4060 E WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90023-2526
Practice Address - Country:US
Practice Address - Phone:323-268-5514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA39555207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A395550Medicaid
C03993Medicare UPIN
CAWA39555JMedicare PIN
A39555Medicare UPIN