Provider Demographics
NPI:1215950829
Name:ELKHOURY, GEORGES F (MD)
Entity type:Individual
Prefix:
First Name:GEORGES
Middle Name:F
Last Name:ELKHOURY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 91989
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90809-1989
Mailing Address - Country:US
Mailing Address - Phone:562-485-5020
Mailing Address - Fax:562-494-6660
Practice Address - Street 1:2650 ELM AVE
Practice Address - Street 2:STE 218
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-1651
Practice Address - Country:US
Practice Address - Phone:562-485-5020
Practice Address - Fax:562-494-6660
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA40394207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A403941Medicaid
CA00A403941Medicaid
CAA40394EMedicare PIN
CAD73188Medicare UPIN