Provider Demographics
NPI:1720242704
Name:NAKHL, FADI E (MD)
Entity Type:Individual
Prefix:DR
First Name:FADI
Middle Name:E
Last Name:NAKHL
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 1:18000 STUDEBAKER RD STE 800
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-2671
Mailing Address - Country:US
Mailing Address - Phone:562-735-3226
Mailing Address - Fax:562-869-1281
Practice Address - Street 1:3628 E IMPERIAL HWY STE 401
Practice Address - Street 2:
Practice Address - City:LYNWOOD
Practice Address - State:CA
Practice Address - Zip Code:90262-2646
Practice Address - Country:US
Practice Address - Phone:310-667-4000
Practice Address - Fax:310-667-4010
Is Sole Proprietor?:No
Enumeration Date:2008-07-18
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01092318A207RH0000X
FLME114963207RH0003X
CAC170297207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008742900Medicaid
FLP01191853OtherRAILROAD MEDICARE PTAN
WVP00656828OtherRAILROAD MEDICARE PTAN
FL008742900Medicaid
WVP00656828OtherRAILROAD MEDICARE PTAN
WV9300761Medicare PIN