Provider Demographics
NPI:1861757320
Name:TOULOEI, KHASHA (DO)
Entity type:Individual
Prefix:
First Name:KHASHA
Middle Name:
Last Name:TOULOEI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 E CHAPMAN AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92866-2231
Mailing Address - Country:US
Mailing Address - Phone:714-538-8556
Mailing Address - Fax:714-538-1082
Practice Address - Street 1:1506 E CHAPMAN AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-2231
Practice Address - Country:US
Practice Address - Phone:714-538-8556
Practice Address - Fax:714-538-1082
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA14183207N00000X
FLUO3035207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty