Provider Demographics
NPI:1891730412
Name:EL-KHOUEIRY, ANTHONY B (MD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:B
Last Name:EL-KHOUEIRY
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 31309
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-0309
Mailing Address - Country:US
Mailing Address - Phone:323-865-3000
Mailing Address - Fax:
Practice Address - Street 1:1441 EASTLAKE AVE
Practice Address - Street 2:NOR 8302E
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90089-0112
Practice Address - Country:US
Practice Address - Phone:323-865-3000
Practice Address - Fax:323-865-0061
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA71334207RH0003X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW11675OtherGROUP MEDICARE PIN
CACE1617OtherGROUP RAILROAD MEDICARE
CA1902846306OtherGROUP NPI
CAGR0100430OtherGROUP MEDICAL
CA1356390009OtherGROUP NPI
CAW18762OtherGROUP MEDICARE
CA00A713340OtherBLUE SHIELD
CAP00296360OtherRAILROAD MEDICARE
CA00A713340197OtherCAL OPTIMA
CAGR0016910OtherGROUP MEDICAID
CA00A713340Medicaid
CA00A713340Medicaid
CAP00296360OtherRAILROAD MEDICARE