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General NPI Number Information
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NPI Number | 1164743464
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Entity Type | Individual
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Provider Name | MARIANNE F MIKHAIL MD
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Gender | Female
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Dates
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Enumeration Date | 06/21/2010
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 5750 DOWNEY AVE STE 206
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City | LAKEWOOD
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State | CA
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Zip | 90712-1474
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Country | US
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Telephone | 562-384-3034
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Fax | 562-408-4901
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Provider Business Mailing Address
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Address Line | 5750 DOWNEY AVE STE 206
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City | LAKEWOOD
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State | CA
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Zip | 90712-1474
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Country | US
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Telephone | 562-384-3034
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Fax | 562-408-4901
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 124526
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License Number State | CA
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