# MED-PED I D INCORPORATED

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245330364
- **Authorized official:** CHAWKI HARFOUCH MD (EMPLOYEE)
- **Authorized official phone:** (951) 679-5811

## Contact information

- **Practice address:** 28078 BAXTER RD, SUITE 320, MURRIETA, CA 92563-1402
- **Practice address phone:** (951) 679-5811
- **Practice address fax:** (951) 679-5844
- **Mailing address:** 28078 BAXTER RD STE 320, MURRIETA, CA 92563-1404
- **Mailing address phone:** (951) 679-5811
- **Mailing address fax:** (951) 679-5844

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RI0200X | Infectious Disease Physician | A60874 | CA | Yes |
| 261QP1100X | Podiatric Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 09/25/2006
- **Last updated:** 09/13/2023