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
931 BUENA VISTA ST STE 102, DUARTE, CA 91010-1780
(626) 303-2525
(626) 303-7664
Mailing address
PO BOX 291040, LOS ANGELES, CA 90029-9040
(818) 994-0804
(818) 994-1288
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0016858
—
CA
Enumeration date
04/27/2007
Last updated
01/15/2008
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