Provider Demographics
NPI:1619255114
Name:KHOURY, JOYCE ANN
Entity Type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:ANN
Last Name:KHOURY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8405 PERSHING DR STE 301
Mailing Address - Street 2:PLAYA DEL REY
Mailing Address - City:PLAYA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90293-7861
Mailing Address - Country:US
Mailing Address - Phone:310-383-6452
Mailing Address - Fax:310-821-7300
Practice Address - Street 1:8405 PERSHING DR STE 301
Practice Address - Street 2:PLAYA DEL REY
Practice Address - City:PLAYA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90293-7861
Practice Address - Country:US
Practice Address - Phone:310-383-6452
Practice Address - Fax:310-821-7300
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist