Organization
PAIN MANAGEMENT MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MEDHAT FOUAD MIKHAEL M.D. (PRESIDENT/OWNER)
(562) 595-0060
Entity
Organization
Contact information
Practice address
3545 LONG BEACH BLVD, SUITE 105, LONG BEACH, CA 90807-3941
(562) 595-0060
(562) 981-0916
Mailing address
3545 LONG BEACH BLVD, SUITE 105, LONG BEACH, CA 90807-3941
(562) 595-0060
(562) 981-0916
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ592332Z
BLUE SHIELD
CA
Enumeration date
07/04/2006
Last updated
08/22/2020
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