Provider Demographics
NPI:1831449040
Name:AQEEL, NOUR (PA)
Entity type:Individual
Prefix:MISS
First Name:NOUR
Middle Name:
Last Name:AQEEL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8101 NEWMAN AVE
Mailing Address - Street 2:STE B
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-7042
Mailing Address - Country:US
Mailing Address - Phone:714-847-3030
Mailing Address - Fax:714-847-7474
Practice Address - Street 1:8101 NEWMAN AVE
Practice Address - Street 2:STE B
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-7042
Practice Address - Country:US
Practice Address - Phone:714-847-3030
Practice Address - Fax:714-847-7474
Is Sole Proprietor?:No
Enumeration Date:2012-09-14
Last Update Date:2020-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015980363AM0700X
CA51349363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical