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Organization
M & M MEDICAL CLINIC INC.
Active
Organization
M & M MEDICAL CLINIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EMMANUEL R. MOFU M.D. (CEO)
(760) 922-3141
Entity
Organization
Contact information
Practice address
495 NORTH MAIN STREET, BLYTHE, CA 92225
(760) 922-3141
Mailing address
495 NORTH MAIN STREET, BLYTHE, CA 92225
(760) 922-3141
(760) 922-3141
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C36558
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C36558
—
CA
Enumeration date
07/23/2013
Last updated
07/23/2013
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