Individual
DR. ABDULLAH KHAN GHOURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2101 N WATERMAN AVE, SAN BERNARDINO, CA 92404-4836
(909) 881-4520
(909) 881-4526
Mailing address
16393 EL REVINO DR, FONTANA, CA 92336-5840
(347) 200-6968
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A96810
CA
208M00000X
Hospitalist Physician
A96810
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A968100
BCBS OF CA
CA
05
—
00A968100
—
CA
01
—
P00472046
RR MEDICARE
CA
Enumeration date
05/06/2007
Last updated
03/07/2023
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