Provider Demographics
NPI:1588706105
Name:GHALY, SABRY FAHMY (MD, MPH, MS)
Entity type:Individual
Prefix:DR
First Name:SABRY
Middle Name:FAHMY
Last Name:GHALY
Suffix:
Gender:M
Credentials:MD, MPH, MS
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Mailing Address - Street 1:21117 LIGHTHILL DR
Mailing Address - Street 2:
Mailing Address - City:TOPANGA
Mailing Address - State:CA
Mailing Address - Zip Code:90290-4438
Mailing Address - Country:US
Mailing Address - Phone:818-314-4692
Mailing Address - Fax:818-702-8612
Practice Address - Street 1:16260 VENTURA BLVD STE 330
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2237
Practice Address - Country:US
Practice Address - Phone:818-789-7937
Practice Address - Fax:818-789-7106
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA45755207R00000X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1588706105Medicare UPIN