Organization
MGM PHYSICIAN ASSISTANT INC
Active
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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