Basic Information
| Provider Information | |||||||||
| NPI: | 1528091170 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ELGHARIB | ||||||||
| FirstName: | SOHA | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 510 N PROSPECT AVE | ||||||||
| Address2: | #320 | ||||||||
| City: | REDONDO BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90277 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3103762716 | ||||||||
| FaxNumber: | 3103749163 | ||||||||
| Practice Location | |||||||||
| Address1: | 510 N PROSPECT AVE | ||||||||
| Address2: | #320 | ||||||||
| City: | REDONDO BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90277 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3103762716 | ||||||||
| FaxNumber: | 3103749163 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2006 | ||||||||
| LastUpdateDate: | 01/29/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | A93220 | CA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.