Provider Demographics
NPI:1942462783
Name:HARFOUCH, CHAWKI (MD)
Entity Type:Individual
Prefix:DR
First Name:CHAWKI
Middle Name:
Last Name:HARFOUCH
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 1:28078 BAXTER RD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-1402
Mailing Address - Country:US
Mailing Address - Phone:951-679-5811
Mailing Address - Fax:951-679-5844
Practice Address - Street 1:28078 BAXTER RD
Practice Address - Street 2:SUITE 320
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-1402
Practice Address - Country:US
Practice Address - Phone:951-679-5811
Practice Address - Fax:951-679-5844
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-01
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA 95225174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist