# 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:** 1558581736
- **Authorized official:** DR. MAHFOUZ M. MICHAEL M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (818) 994-0804

## Contact information

- **Practice address:** 931 BUENA VISTA ST STE 102, DUARTE, CA 91010-1780
- **Practice address phone:** (626) 303-2525
- **Practice address fax:** (626) 303-7664
- **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 |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |

## Other

- **Enumeration date:** 04/27/2007
- **Last updated:** 01/15/2008