Provider Demographics
NPI:1992169643
Name:KAMEL, BISHOY (M D)
Entity type:Individual
Prefix:
First Name:BISHOY
Middle Name:
Last Name:KAMEL
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3367 OVERLAND AVE APT 7
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-7304
Mailing Address - Country:US
Mailing Address - Phone:310-710-9102
Mailing Address - Fax:
Practice Address - Street 1:27141 HIDAWAY AVE STE 204
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91351-4147
Practice Address - Country:US
Practice Address - Phone:661-397-1177
Practice Address - Fax:661-367-6175
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-08
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA156933208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty