Healthcare Provider Details

I. General information

NPI: 1740532910
Provider Name (Legal Business Name): MAGDI MESSIHA, M.D. , INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2012
Last Update Date: 10/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 W KATELLA AVE SUITE 272
ORANGE CA
92867-4750
US

IV. Provider business mailing address

303 W KATELLA AVE SUITE 272
ORANGE CA
92867-4750
US

V. Phone/Fax

Practice location:
  • Phone: 714-633-1400
  • Fax: 714-633-1405
Mailing address:
  • Phone: 714-633-1400
  • Fax: 714-633-1405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA63313
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberA63313
License Number StateCA

VIII. Authorized Official

Name: DR. MAGDI MESSIHA
Title or Position: CEO
Credential: M.D.
Phone: 714-633-1400