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
954 N VERMONT AVE, LOS ANGELES, CA 90029-3529
(323) 666-6866
(323) 666-9996
Mailing address
PO BOX 291040, LOS ANGELES, CA 90029-9040
(818) 994-0804
(919) 994-1288
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
207VG0400X
Gynecology Physician
—
—
207VX0000X
Obstetrics Physician
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0029860
—
CA
Enumeration date
04/27/2007
Last updated
08/23/2007
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