Provider Demographics
NPI:1225448616
Name:KHALIL, ADAM M (MD)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:M
Last Name:KHALIL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:280 SIERRA COLLEGE DR STE 120
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-5763
Practice Address - Country:US
Practice Address - Phone:530-477-4480
Practice Address - Fax:530-274-7532
Is Sole Proprietor?:No
Enumeration Date:2014-05-06
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CODR.00714462085R0204X, 2085R0204X
CAA1828622085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty