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Organization
MAHFOUZ M. MICHAEL,M.D.,INC.
Active
Organization
MAHFOUZ M. MICHAEL,M.D.,INC.
Active
Other names
Clinica Medica San Miguel
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAHFOUZ M. MICHAEL M.D. (MEDICAL DIRECTOR)
(818) 266-6432
Entity
Organization
Contact information
Practice address
1500 GLENOAKS BLVD, SAN FERNANDO, CA 91340-1780
(818) 898-7171
(818) 898-7172
Mailing address
PO BOX 291040, LOS ANGELES, CA 90029-9040
(818) 994-0804
(818) 994-1288
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RR0500X
Rheumatology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
208D00000X
General Practice Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0016859
—
CA
Enumeration date
04/25/2007
Last updated
01/31/2008
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