Individual
DR. ABDALLAH KHOURDAJI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 S HAM LN, STE A, LODI, CA 95242-7501
(209) 333-6110
(209) 333-0724
Mailing address
801 S HAM LN, STE A, LODI, CA 95242-7501
(209) 333-6110
(209) 333-0724
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
00A341430
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070001716
RAILROAD MEDICARE
CA
Enumeration date
12/06/2005
Last updated
08/11/2010
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