Organization
WADIE ALKHOURI MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WADIE ALKHOURI MD (OWNER/PRESIDENT/CEO)
(626) 335-1919
Entity
Organization
Contact information
Practice address
210 S. GRAND AVE, SUITE 320, GLENDORA, CA 91741-4286
(626) 335-1919
(626) 335-1911
Mailing address
210 S. GRAND AVE, SUITE 320, GLENDORA, CA 91741-4286
(626) 335-1919
(626) 335-1911
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
C51885
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000518850
—
CA
01
—
1568556652
TYPE 1 NPI
CA
Enumeration date
07/12/2013
Last updated
07/14/2016
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