Healthcare Provider Details

I. General information

NPI: 1215129986
Provider Name (Legal Business Name): MAGUED RIZK M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2007
Last Update Date: 09/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 4TH ST
TAFT CA
93268-2415
US

IV. Provider business mailing address

1100 4TH ST
TAFT CA
93268-2415
US

V. Phone/Fax

Practice location:
  • Phone: 800-300-6664
  • Fax:
Mailing address:
  • Phone: 800-300-6664
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMT189785
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01069757A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35.122125
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberC138797
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: