Provider Demographics
NPI:1982628228
Name:KAMEL, EMAN SHOUKRI (MD)
Entity Type:Individual
Prefix:
First Name:EMAN
Middle Name:SHOUKRI
Last Name:KAMEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1456 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91201-1214
Mailing Address - Country:US
Mailing Address - Phone:818-240-0907
Mailing Address - Fax:818-247-4887
Practice Address - Street 1:1456 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91201-1214
Practice Address - Country:US
Practice Address - Phone:818-240-0907
Practice Address - Fax:818-247-4887
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA81115207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A811150OtherBLUE SHIELD
CA00A811150Medicaid
H99666Medicare UPIN
CAWA81115AMedicare ID - Type Unspecified