Individual
DR. MOHAMMAD KHALIFEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5757 WILSHIRE BLVD.,, SUITE # 5, LOS ANGELES, CA 90036
(323) 933-3855
Mailing address
5757 WILSHIRE BLVD.,, SUITE # 5, LOS ANGELES, CA 90036
(323) 933-3855
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
40631
CA
1223G0001X
General Practice Dentistry
40631
CA
1223X2210X
Orofacial Pain Dentistry
Primary
40631
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
47-0910768
TAXPAYER IDENTIFYING NUMB
—
Enumeration date
10/10/2006
Last updated
06/29/2024
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