Individual
DR. SHADI KHALIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
15004 INNOVATION DR, SAN DIEGO, CA 92128-3491
(858) 605-7808
Mailing address
10790 RANCHO BERNARDO RD, SAN DIEGO, CA 92127-5705
(858) 605-7808
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A178244
CA
207ND0900X
Dermatopathology Physician
330949
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/16/2019
Last updated
08/14/2025
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