Provider Demographics
NPI:1285622068
Name:EID, WAEL (MD)
Entity type:Individual
Prefix:
First Name:WAEL
Middle Name:
Last Name:EID
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 1:1801 W OLYMPIC BLVD # 1270
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91199-0001
Mailing Address - Country:US
Mailing Address - Phone:702-791-1454
Mailing Address - Fax:702-946-1354
Practice Address - Street 1:6040 S FORT APACHE RD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-5613
Practice Address - Country:US
Practice Address - Phone:702-476-4900
Practice Address - Fax:702-476-4949
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10229207RC0200X, 207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVEF514ZMedicare PIN
NVV103575Medicare PIN