Individual
DR. EBTESAM KHALED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
17772 BEACH BLVD, HUNTINGTON BEACH, CA 92647-6819
(909) 305-0714
(909) 394-7415
Mailing address
PO BOX 131, HUNTINGTON BEACH, CA 92648-0131
(714) 375-2077
(714) 375-2082
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A49538
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A495382
—
CA
Enumeration date
09/15/2006
Last updated
01/17/2017
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