Active NPI
Mahfouz M. Michael,M.D.,Inc
- Internal Medicine Physician
- Los Angeles, CA
National Provider Identifier
1609095603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- MAHFOUZ M. MICHAEL,M.D.,INC
- Practice address
- 1101 N Vermont Ave
Los Angeles, CA 90029-1701 - Phone
- (323) 665-4230
- Fax
- (323) 665-8718
- NPI assigned
- Apr 25, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mahfouz M. Michael, M.D.
- Title
- Medical Director
- Phone
- (818) 266-6432
Specialties & licenses 9
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | |||
| Family Medicine Physician | 207Q00000X | |||
| Internal Medicine Physician | 207R00000X | Primary | ||
| Cardiovascular Disease Physician | 207RC0000X | |||
| Rheumatology Physician | 207RR0500X | |||
| Urology Physician | 208800000X | |||
| General Practice Physician | 208D00000X | |||
| Podiatrist | 213E00000X | |||
| Physician Assistant | 363A00000X |
Addresses
Primary practice location
1101 N Vermont Ave
Los Angeles, CA 90029-1701
Mailing address
PO Box 291040
Los Angeles, CA 90029-9040
Phone (818) 994-0804
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0016853 | Medicaid | CA |
Other names 1
- Clinica Medica San Miguel
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177459200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1203033600000",
"number": "1609095603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 291040",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900299040",
"telephone_number": "818-994-0804",
"fax_number": "818-994-1288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 N VERMONT AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900291701",
"telephone_number": "323-665-4230",
"fax_number": "323-665-8718"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MAHFOUZ M. MICHAEL,M.D.,INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-04-25",
"last_updated": "2008-02-15",
"status": "A",
"authorized_official_last_name": "MICHAEL",
"authorized_official_first_name": "MAHFOUZ",
"authorized_official_middle_name": "M.",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "818-266-6432",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dermatology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207RC0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RR0500X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Rheumatology",
"state": null,
"license": null,
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Urology",
"state": null,
"license": null,
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "General Practice",
"state": null,
"license": null,
"primary": false
},
{
"code": "213E00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Podiatrist",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0016853",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Clinica Medica San Miguel",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.