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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
MAHFOUZ M. MICHAEL M.D. (MEDICAL DIRECTOR)
(818) 266-6432
Entity
Organization
Contact information
Practice address
2618 S WESTERN AVE, LOS ANGELES, CA 90018-2627
(323) 730-9000
(323) 730-4825
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
Primary
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
208D00000X
General Practice Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0016852
—
CA
Enumeration date
04/27/2007
Last updated
08/22/2007
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