# MAHFOUZ M. MICHAEL,M.D.,INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Clinica Medica San Miguel
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134348261
- **Authorized official:** MAHFOUZ M. MICHAEL M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (818) 994-0804

## Contact information

- **Practice address:** 7128 PACIFIC BLVD, SUITE A, HUNTINGTON PARK, CA 90255-4776
- **Practice address phone:** (323) 586-0144
- **Practice address fax:** (323) 586-0629
- **Mailing address:** PO BOX 291040, LOS ANGELES, CA 90029-9040
- **Mailing address phone:** (818) 994-0804
- **Mailing address fax:** (818) 994-1288

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 2085U0001X | Diagnostic Ultrasound Physician | — | NULL | — |
| 2085U0001X | Diagnostic Ultrasound Physician | — | — | — |

## Other

- **Enumeration date:** 04/25/2007
- **Last updated:** 11/26/2007