Organization
MMJ MEDICAL INC,
Active
Organization
MMJ MEDICAL INC,
Active
Other names
Gastroenterology and therapeutic endoscopy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMMAD MAZEN JAMAL M.D/MPH (OWNER)
(949) 813-5115
Entity
Organization
Contact information
Practice address
1810 FULLERTON AVE, SUITE 203, CORONA, CA 92881
(951) 934-0505
(951) 934-0506
Mailing address
29 PRAIRIE, IRVINE, CA 92618-8840
(949) 825-5188
(949) 825-5189
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
A46078
CA
Other
Enumeration date
08/28/2012
Last updated
11/16/2012
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