Maged S Mikhail a Professional Corporation

Primary specialty

SpecialistTaxonomy code 174400000X

License

G45367 Issued in CA

Legal business name

MAGED S MIKHAIL A PROFESSIONAL CORPORATION

Doing business as

Los Angeles Varicose Vein Center

Practice address

18425 Burbank Blvd.
Suite #102
Tarzana, CA 91356-2806

Phone

(818) 654-0520

Fax

(818) 654-0596

NPI assigned

Jan 16, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Maged S. Mikhail, M.D.

Title

President

Phone

(818) 654-0520

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• LOS ANGELES VARICOSE VEIN CENTER Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242000000000",
    "number": "1427109388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18425 BURBANK BLVD",
            "address_2": "SUITE #102",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913562806",
            "telephone_number": "818-654-0520",
            "fax_number": "818-654-0596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18425 BURBANK BLVD.",
            "address_2": "SUITE #102",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913562806",
            "telephone_number": "818-654-0520",
            "fax_number": "818-654-0596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGED S MIKHAIL A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2009-05-11",
        "status": "A",
        "authorized_official_last_name": "MIKHAIL",
        "authorized_official_first_name": "MAGED",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-654-0520",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G45367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G453670",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LOS ANGELES VARICOSE VEIN CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rachel Elizabeth Maciel
• Lauren Mackenzie
• Michael Madievsky, MD
• Sadek Magades, M.S.
• Richard Magallanes Jr.
• Ronit Maghen, RD
• Larisa Magid, PA-C
• Liliana Maria Magnanimo
• Magnolia Counseling
• Magnolia Counseling

• Specialist in Tarzana, CA
• Providers in Tarzana, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.