Provider Demographics
NPI:1982787057
Name:FEGHALI, NABIL SALLOUM (MD)
Entity Type:Individual
Prefix:DR
First Name:NABIL
Middle Name:SALLOUM
Last Name:FEGHALI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8111 CANOGA AVENUE
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91304
Mailing Address - Country:US
Mailing Address - Phone:818-704-7200
Mailing Address - Fax:818-704-3964
Practice Address - Street 1:8111 CANOGA AVE
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91304-4198
Practice Address - Country:US
Practice Address - Phone:818-704-7200
Practice Address - Fax:818-704-3964
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA34704207QA0505X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A347040Medicaid
CA5167738Medicaid
CAWA34704AMedicare PIN