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Individual

ATEF KHOUZAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
361 HOSPITAL RD, 322, NEWPORT BEACH, CA 92663-3522
(949) 574-0777
(949) 650-3505
Mailing address
PO BOX 3579, NEWPORT BEACH, CA 92659-8579
(949) 574-0777
(949) 650-3505

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A40228
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110125134
MEDICARE RAILROAD
CA
Enumeration date
06/08/2006
Last updated
05/14/2008
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