Healthcare Provider Details
I. General information
NPI: 1285353128
Provider Name (Legal Business Name): MICHAEL MAGDY HABIB OD, MS, FAAO
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/24/2022
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5460 E LA PALMA AVE
ANAHEIM CA
92807-2023
US
IV. Provider business mailing address
2575 YORBA LINDA BLVD
FULLERTON CA
92831-1699
US
V. Phone/Fax
- Phone: 714-463-7500
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | 34955 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: