Provider Demographics
NPI:1447360573
Name:DOANY, WALEED (MD)
Entity type:Individual
Prefix:DR
First Name:WALEED
Middle Name:
Last Name:DOANY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18399 VENTURA BLVD
Mailing Address - Street 2:SUITE 249
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-4233
Mailing Address - Country:US
Mailing Address - Phone:818-345-2455
Mailing Address - Fax:818-344-3101
Practice Address - Street 1:18399 VENTURA BLVD
Practice Address - Street 2:SUITE 249
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-4233
Practice Address - Country:US
Practice Address - Phone:818-345-2455
Practice Address - Fax:818-344-3101
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA41218174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A412181Medicaid
CA00A412181Medicaid
CAA41218Medicare ID - Type Unspecified