MEDICARE: MAHFOUZ M. MICHAEL,M.D.,INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207N00000X	Dermatology Physician
2	207Q00000X	Family Medicine Physician
3	207RC0000X	Cardiovascular Disease Physician
4	207RR0500X	Rheumatology Physician
5	208800000X	Urology Physician
6	208D00000X	General Practice Physician
7	213E00000X	Podiatrist
8	363A00000X	Physician Assistant
9	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609095603
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAHFOUZ M. MICHAEL,M.D.,INC

Provider Business Mailing Address
First Line	:	PO BOX 291040
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90029-9040
Country	:	US
Telephone Number	:	818-994-0804
Fax Number	:	818-994-1288

Provider Business Practice Location Address
First Line	:	1101 N VERMONT AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90029-1701
Country	:	US
Telephone Number	:	323-665-4230
Fax Number	:	323-665-8718

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	MAHFOUZ M. MICHAEL
Credential	:	M.D.
Telephone Number	:	818-266-6432

Provider Enumeration Date	:	04/25/2007
Last Update Date	:	02/15/2008

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Directions to “MAHFOUZ M. MICHAEL,M.D.,INC ” Practice Location

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