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General NPI Number Information
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NPI Number | 1053783258
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Entity Type | Organization
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Legal Business Name | MICHAEL F. SEDRAK, M.D., A MEDICAL CORPORATION
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Dates
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Enumeration Date | 10/27/2015
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 10336 WILSHIRE BLVD APT 602
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City | LOS ANGELES
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State | CA
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Zip | 90024-4754
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Country | US
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Telephone | 310-728-0494
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Fax | 619-209-7888
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Provider Business Mailing Address
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Address Line | 1902 FULLERTON AVE STE 101
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City | CORONA
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State | CA
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Zip | 92881-3112
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Country | US
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Telephone | 951-479-8994
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Fax | 619-209-7888
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL FAYEZ SEDRAK
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Credential | MD
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Telephone | 310-728-0494
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A82582
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License Number State | CA
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