Organization
MAHFOUZ M. MICHAEL,M.D.,INC.
Active
Other names
Clinica Medica San Miguel
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAHFOUZ M. MICHAEL M.D. (MEDICAL DIRECTOR)
(818) 994-0804
Entity
Organization
Contact information
Practice address
1437 S ATLANTIC BLVD, LOS ANGELES, CA 90022-5015
(323) 268-9900
(323) 268-4993
Mailing address
PO BOX 291040, LOS ANGELES, CA 90029-9040
(818) 994-0804
(818) 994-1288
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RR0500X
Rheumatology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207W00000X
Ophthalmology Physician
—
—
208000000X
Pediatrics Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0029510
—
CA
Enumeration date
04/25/2007
Last updated
08/22/2007
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