Organization
MGM PHYSICIAN ASSISTANT INC
Active
Other names
La Casa Wound Specialist
Organization subpart
No
Provider details
NPI number
Authorized official
GINA HABEEB PA (CEO)
(951) 788-2224
Entity
Organization
Contact information
Practice address
1525 3RD ST STE 205, RIVERSIDE, CA 92507-9000
(310) 810-6554
Mailing address
1525 3RD ST STE 205, RIVERSIDE, CA 92507-9000
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
02/05/2024
Last updated
12/03/2025
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