Individual
ANTOINE E KHOURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
505 S MAIN ST STE 100, ORANGE, CA 92868-4568
(714) 509-3919
(714) 509-3917
Mailing address
PO BOX 51342, LOS ANGELES, CA 90051-5642
(714) 509-3910
(714) 509-3917
Taxonomy
Speciality
Code
Description
License number
State
2088P0231X
Pediatric Urology Physician
Primary
C53187
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GR0085140
MEDICAID GRP
CA
01
—
W14887
MEDICARE GROUP
CA
Enumeration date
03/13/2008
Last updated
04/29/2014
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