LEILA KHADDOUR (NPI# 1750797486) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1750797486 |
Entity Type | Individual |
Full Name | LEILA KHADDOUR |
Credential | MD |
Practice Address |
3123 Medical Dr Caldwell ID 83605-6972 |
Mailing Address |
3340 E Goldstone Dr Meridian ID 83642-1026 |
Practice Telephone | 2083673131 |
Practice Fax Number | 2083674817 |
Mailing Telephone | 2083675170 |
Mailing Fax Number | 2083675180 |
Enumeration Date | 2014-07-02 |
Last Update Date | 2020-09-18 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207R00000X | Internal Medicine | 4301105339 | MI | Allopathic & Osteopathic Physicians |
Y | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
MC-0480 | ID | Allopathic & Osteopathic Physicians |
N | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
4301105339 | MI | Allopathic & Osteopathic Physicians |
Address | Telephone Number | Fax Number |
---|---|---|
2799 W Grand Blvd, Detroit, MI 482022608 | (313) 916-2600 |
Street Address |
3123 MEDICAL DR |
City | CALDWELL |
State | ID |
Zip Code | 83605-6972 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053522961 | Saint Alphonsus Caldwell Cancer Treatment Center LLC | Radiologic Technologist | 3123 Medical Dr, Caldwell, ID 83605-6911 | 2007-05-24 |
1598956963 | Bobby Chawla | Internal Medicine | 3123 Medical Dr, Caldwell, ID 83605 | 2007-08-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518585660 | Laurie Bernstein | Occupational Therapist | 2205 Sunset Avenue, Caldwell, ID 83605 | 2020-07-06 |
1881249316 | Elevate Academy | Local Education Agency (LEA) | 114 W. Chicago St., Caldwell, ID 83605 | 2019-08-01 |
1669025359 | James Smith | Pharmacist | 2809 E Caldwell Blvd, Caldwell, ID 83605 | 2019-07-22 |
1164910824 | Michelle Stoddard | Physician Assistant | 315 E Elm St Ste 200, Caldwell, ID 83605 | 2018-04-27 |
1215430483 | Amy E Rudolf | Pharmacist | 315 E Elm St Ste 150, Caldwell, ID 83605 | 2018-03-14 |
1871044883 | Kool Ridez LLC | Case Management | 1803 Ellis Ave., Caldwell, ID 83605 | 2016-10-14 |
1932550795 | Chris Torgerson | Social Worker | 3402 Franklin Blvd, Caldwell, ID 83605 | 2016-06-23 |
1609237742 | Peggy A Mcfarland | Counselor | 534 Cleveland Suite 230, Caldwell, ID 83605 | 2016-03-17 |
1720468101 | Devin Douglas Dredge | Emergency Medicine | 1717 Arlington Ave Dept Of, Caldwell, ID 83605 | 2015-06-01 |
1578950168 | Trinidad Bridge | Licensed Practical Nurse | 2909 S. 10th Avenue, Caldwell, ID 83605 | 2015-04-21 |
Find all providers in zip 83605 |
Taxonomy Code | 207RX0202X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Medical Oncology |
An internist who specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers therapy for these malignancies as well as consults with surgeons and radiotherapists on other treatments for cancer. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source. 11/5/2007: corrected definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376567487 | Teresa Gray Hayes | Internal Medicine | 700 W Ironwood Dr Ste 130, Coeur D Alene, ID 83814-4404 | 2006-07-26 |
1215981832 | Gerardo Midence | Internal Medicine | 1250 Idaho Street, Lewiston, ID 83501 | 2006-05-19 |
1821355330 | Jessica Thibault | Internal Medicine | 725 Pole Line Rd W, Twin Falls, ID 83301 | 2012-04-20 |
1417214420 | Nathanael David Gay | Internal Medicine | 1440 E Mullan Ave, Post Falls, ID 83854 | 2012-04-15 |
1629095179 | St Alphonsus Professional Medical Services LLC | Internal Medicine | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2006-07-17 |
1265478325 | Karl Josef Schultheiss | Internal Medicine | 1055 N Curtis Rd, Boise, ID 83706 | 2006-06-20 |
1093753360 | Michael Rooney | Internal Medicine | 415 6th St, Lewiston, ID 83501-2431 | 2006-06-02 |
1083668248 | Sushma Pant | Internal Medicine | 1250 Idaho Street, Lewiston, ID 83501 | 2006-05-20 |
1821042029 | Katrina A Rolen | Internal Medicine | 1250 Idaho Street, Lewiston, ID 83501 | 2006-05-20 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.