Provider Demographics
NPI:1023101888
Name:KHOURY, ADNAN ELIAS (MD)
Entity type:Individual
Prefix:DR
First Name:ADNAN
Middle Name:ELIAS
Last Name:KHOURY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:13351 RIVERSIDE DR
Mailing Address - Street 2:BOX 233
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-2542
Mailing Address - Country:US
Mailing Address - Phone:818-421-4871
Mailing Address - Fax:818-907-9121
Practice Address - Street 1:9449 SAN FERNANDO ROAD
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-1421
Practice Address - Country:US
Practice Address - Phone:818-421-4871
Practice Address - Fax:818-907-9121
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2018-09-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA686592084P0800X, 2084A0401X, 2084F0202X, 2084P0005X, 2084P0804X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
No2084P0005XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurodevelopmental Disabilities
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI-05868Medicare UPIN
CAA68659Medicare PIN