Individual provider · NPI-1

Khalid Ibrahim Khawaldeh, RN, BSN

Registered Nurse, General Practice · Anaheim, CA

NPI number1336401249
StatusActive
Last updated in NPPESJun 15, 2012

Details

NPI
1336401249
Entity type
Individual (NPI-1)
Name
Khalid Ibrahim Khawaldeh
Credential
RN, BSN
Sex
Male
Sole proprietor
Yes
Enumeration date
Jun 15, 2012
Last updated
Jun 15, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
163WG0000X Registered Nurse, General Practice567797CAYes

Practice location

3359 W Thornton Ave
Anaheim, CA 92804-4714

Phone 714-553-4314

Mailing address

3359 W Thornton Ave
Anaheim, CA 92804-4714

Phone 714-553-4314

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