# 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:** 1659591832
- **Authorized official:** DR. MAHFOUZ M. MICHAEL M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (818) 994-0804

## Contact information

- **Practice address:** 954 N VERMONT AVE, LOS ANGELES, CA 90029-3529
- **Practice address phone:** (323) 666-6866
- **Practice address fax:** (323) 666-9996
- **Mailing address:** PO BOX 291040, LOS ANGELES, CA 90029-9040
- **Mailing address phone:** (818) 994-0804
- **Mailing address fax:** (919) 994-1288

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |
| 207VG0400X | Gynecology Physician | — | NULL | — |
| 207VG0400X | Gynecology Physician | — | — | — |
| 207VX0000X | Obstetrics Physician | — | NULL | — |
| 207VX0000X | Obstetrics Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |

## Other

- **Enumeration date:** 04/27/2007
- **Last updated:** 08/23/2007