Healthcare Provider Details

I. General information

NPI: 1922167774
Provider Name (Legal Business Name): MICHAEL HABASHY MD A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2031 W ALAMEDA AVE SUIT # 340
BURBANK CA
91506-2958
US

IV. Provider business mailing address

1456 WESTERN AVE
GLENDALE CA
91201-1214
US

V. Phone/Fax

Practice location:
  • Phone: 818-636-9444
  • Fax:
Mailing address:
  • Phone: 818-240-0907
  • Fax: 818-247-4887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL FAROUK HABASHY
Title or Position: PHYSICIAN
Credential: M.D
Phone: 818-636-9444