Individual provider Active NPI

Mahfouz M Michael, MD

  • Family Medicine Physician
  • Huntington Park, CA
National Provider Identifier
1447369103
Registry record updated Nov 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A34248 Issued in CA
Practice address
5417 Pacific Blvd
Huntington Park, CA 90255-2532
Phone
(323) 923-4160
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A34248 CA Primary

Addresses

Primary practice location

5417 Pacific Blvd
Huntington Park, CA 90255-2532

Mailing address

5417 Pacific Blvd
Huntington Park, CA 90255-2532
Phone (323) 923-4160

Other identifiers 1

IdentifierTypeStateIssuer
00A34248MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060213000587 CA Practitioner - Family Practice 4789585779 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8781 Van Nuys Blvd
Panorama City, CA 91402-2401
Phone (818) 920-0303

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue18
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A34248CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Miguel Urgent Care Orange County Family Medicine CurrentSince Dec 8, 2021 Accepting new patients
San Miguel Urgent Care Panorama City CurrentSince Sep 22, 2021 Accepting new patients
San Miguel Urgent Care & Industrial Clinic CurrentSince May 12, 2021 Accepting new patients
Clinica Medica San Miguel Past Accepting new patients
Mahfouz M. Michael,M.D.,Inc. Past Accepting new patients
Mahfouz M. Michael,M.D., Inc. Family Medicine PastSince Sep 5, 2023 Accepting new patients
Longevity Hospice, Inc. PastSince Mar 10, 2016 Accepting new patients
San Miguel Urgent Care Anaheim a Professional Corporation PastSince Jun 26, 2017 Accepting new patients
Mahfouz M. Michael,M.D., Inc. Family Medicine Past Accepting new patients
Mahfouz M. Michael,M.D., Inc. Family Medicine Past Accepting new patients

Locations

980 S Euclid St
Anaheim, CA 92802
Phone (657) 254-0080

404 W 9th St
Sn Bernrdno, CA 92401
Phone (909) 383-0050

8781 Van Nuys Blvd
Van Nuys, CA 91402
Phone (818) 920-0303

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320796800000",
    "number": "1447369103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5417 PACIFIC BLVD",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902552532",
            "telephone_number": "323-923-4160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5417 PACIFIC BLVD",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902552532",
            "telephone_number": "323-923-4160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAEL",
        "first_name": "MAHFOUZ",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2011-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A34248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A34248",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Park, CA

Sources for this page

Verify at the official NPI Registry.