Dr. Khalafi, Md, Llc | |
4200 Warrensville Center Rd Suite 430 Beachwood OH 44122-7051 | |
(216) 491-7660 | |
(216) 491-7662 |
Full Name | Dr. Khalafi, Md, Llc |
---|---|
Speciality | Internal Medicine |
Location | 4200 Warrensville Center Rd, Beachwood, Ohio |
Authorized Official Name and Position | Kamal Khalafi (OWNER) |
Authorized Official Contact | 2164917660 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Dr. Khalafi, Md, Llc P.o. Box 391405 Solon OH 44139 Ph: (216) 491-7660 | Dr. Khalafi, Md, Llc 4200 Warrensville Center Rd Suite 430 Beachwood OH 44122-7051 Ph: (216) 491-7660 |
NPI Number | 1417037664 |
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Provider Enumeration Date | 10/16/2006 |
Last Update Date | 07/09/2015 |
Medicare PECOS PAC ID | 4284650151 |
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Medicare Enrollment ID | O20051020000040 |
Identifier | Type | State | Issuer |
---|---|---|---|
1417037664 | NPI | - | NPPES |
2718410 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 35074605K (Ohio) | Primary |
Provider Name | Kamal Khalafi |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1992791263 PECOS PAC ID: 9931185246 Enrollment ID: I20040628000533 |
Provider Name | Tiffaney M Moore |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1609418946 PECOS PAC ID: 7618309352 Enrollment ID: I20191118001745 |
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