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Organization
KNEE SHOULDER BACK ORTHOPEDIC MEDICAL GROUP, A PROFESSIONAL CORPORATIO
Active
Organization
KNEE SHOULDER BACK ORTHOPEDIC MEDICAL GROUP, A PROFESSIONAL CORPORATIO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAHFOUZ MICHAEL MD (OWNER)
(323) 999-8267
Entity
Organization
Contact information
Practice address
5417 PACIFIC BLVD STE B, HUNTINGTON PARK, CA 90255-2532
(323) 581-0101
Mailing address
PO BOX 291040, LOS ANGELES, CA 90029-9040
Taxonomy
Speciality
Code
Description
License number
State
111NX0800X
Orthopedic Chiropractor
—
NULL
111NX0800X
Orthopedic Chiropractor
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
NULL
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
NULL
208VP0014X
Interventional Pain Medicine Physician
—
—
261QP3300X
Pain Clinic/Center
—
NULL
Other
Enumeration date
03/13/2023
Last updated
03/13/2023
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