Provider Demographics
NPI:1942342472
Name:KHALIL, ABDULLAH (MD)
Entity Type:Individual
Prefix:DR
First Name:ABDULLAH
Middle Name:
Last Name:KHALIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:436 N ROXBURY DR STE 207
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5017
Mailing Address - Country:US
Mailing Address - Phone:310-663-8554
Mailing Address - Fax:310-492-9974
Practice Address - Street 1:436 N ROXBURY DR STE 207
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210
Practice Address - Country:US
Practice Address - Phone:310-385-8601
Practice Address - Fax:310-492-9974
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA94269208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI125-653Medicare UPIN