Organization
FOUR M MEDICAL MART A MEDICAL CORPORATION
Active
Other names
San Miguel Occupational & Urgent Care Medical Group Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MAHFOUZ M MICHAEL MD (MEDICAL DIRECTOR)
(818) 994-0804
Entity
Organization
Contact information
Practice address
11432 VANOWEN STREET, NORTH HOLLYWOOD, CA 91605-6220
(818) 503-9999
(818) 503-0675
Mailing address
PO BOX 291040, LOS ANGELES, CA 90029-9040
(818) 994-0804
(818) 994-4117
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
—
—
Other
Enumeration date
03/08/2007
Last updated
08/22/2020
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