Organization
MAGED M FARAGALLA, MD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NAGY BEBAWY M.D. (MEDICAL DIRECTOR/OWNER)
(323) 584-8700
Entity
Organization
Contact information
Practice address
605 N MEDNIK AVE, LOS ANGELES, CA 90022-1326
(323) 326-6700
(323) 262-0006
Mailing address
2542 E FLORENCE AVE, SUITE B, WALNUT PARK, CA 90255-4774
(323) 584-8700
(323) 584-5472
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
CA
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447337241
—
CA
Enumeration date
11/01/2006
Last updated
11/09/2012
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