Individual
DR. ISAM HANNA KHOURY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1500 SOUTHGATE AVE, #103, DALY CITY, CA 94015-2259
(650) 991-0999
(650) 991-0918
Mailing address
1500 SOUTHGATE AVE, #103, DALY CITY, CA 94015-2259
(650) 991-0999
(650) 991-0918
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DP035922
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B35922-01
—
CA
Enumeration date
12/29/2006
Last updated
07/08/2007
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