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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Thursday, December 19, 2024 3:44 AM CST
Next Update: Thursday, December 19, 2024 12:00 PM CST

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MOGANNAM, PAUL NABEEL       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: 1721 ANDOVER WAY
11692 DARLINGTON AVE APT 301
PETALUMA CA 94954

Address last updated on 9/2/2024
Phone #: (310) 962-1386
Fax #:
County: NOT OKLAHOMA
License: 32574
Dated: 11/14/2016
Expires: 11/1/2025
License Type: Medical Doctor
Specialty: Diagnostic Radiology
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: Chicago Med Sch at Rosalin Franklin Univ of Med & Sci, North Chicago, IL
Graduated: 6 / 2002
CME Year: 2025
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications: AMERICAN BOARD OF RADIOLOGY
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
1721 ANDOVER WAY
11692 DARLINGTON AVE APT 301
PETALUMA CA 94954

Phone #: (310) 962-1386
Fax #:
Mon: 9:00PM - 6:00PM
Tue: 9:00PM - 6:00PM
Wed: 9:00PM - 6:00PM
Thu: 9:00PM - 6:00PM
Fri: 9:00PM - 6:00PM
Sat: 9:00AM - 6:00PM
Sun: 9:00PM - 0:00PM

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