Provider Demographics
NPI:1669776845
Name:MARWA KILANI, M.D.
Entity type:Organization
Organization Name:MARWA KILANI, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARWA
Authorized Official - Middle Name:
Authorized Official - Last Name:KILANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-429-7246
Mailing Address - Street 1:21781 VENTURA BLVD
Mailing Address - Street 2:#510
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-1835
Mailing Address - Country:US
Mailing Address - Phone:310-429-7246
Mailing Address - Fax:
Practice Address - Street 1:21781 VENTURA BLVD
Practice Address - Street 2:#510
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-1835
Practice Address - Country:US
Practice Address - Phone:310-429-7246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-03
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA77118207R00000X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty