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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) 994-0804
Entity
Organization
Contact information
Practice address
115 E WASHINGTON BLVD, 122 E. WASHINGTON BLVD., LOS ANGELES, CA 90015-3606
(213) 749-6500
(213) 749-4765
Mailing address
PO BOX 291040, LOS ANGELES, CA 90029-9040
(818) 994-0804
(818) 994-1288
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
111N00000X
Chiropractor
—
—
207N00000X
Dermatology Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207RR0500X
Rheumatology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207W00000X
Ophthalmology Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
208000000X
Pediatrics Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
208D00000X
General Practice Physician
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0016857
—
CA
Enumeration date
04/25/2007
Last updated
03/11/2008
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