Individual
ELVIRA KHALIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4424 BONITA RD, BONITA, CA 91902-1423
(619) 473-0392
Mailing address
4424 BONITA RD, BONITA, CA 91902-1423
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
23720
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
538938891
PASSPORT
—
Enumeration date
05/30/2018
Last updated
05/30/2018
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