Provider Demographics
NPI:1699823021
Name:BATNIJI, KAMAL A (MD)
Entity Type:Individual
Prefix:DR
First Name:KAMAL
Middle Name:A
Last Name:BATNIJI
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 1:361 HOSPITAL RD
Mailing Address - Street 2:SUITE #329
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-3522
Mailing Address - Country:US
Mailing Address - Phone:949-650-8882
Mailing Address - Fax:949-650-2293
Practice Address - Street 1:361 HOSPITAL RD
Practice Address - Street 2:SUITE #329
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3522
Practice Address - Country:US
Practice Address - Phone:949-650-8882
Practice Address - Fax:949-650-2293
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA25477207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A254770Medicaid
CAA24457Medicare UPIN