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General NPI Number Information
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NPI Number | 1245420199
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Entity Type | Organization
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Legal Business Name | ISKANDER MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 07/26/2007
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Last Update Date | 04/17/2018
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Provider Practice Location Address
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Address Line | 4477 W 118TH ST STE 301
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City | HAWTHORNE
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State | CA
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Zip | 90250-2258
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Country | US
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Telephone | 310-978-8026
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Fax | 310-978-1408
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Provider Business Mailing Address
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Address Line | 4477 W 118TH ST STE 301
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City | HAWTHORNE
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State | CA
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Zip | 90250-2258
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Country | US
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Telephone | 310-978-8026
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Fax | 310-978-1408
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MONA YOUSSEF ISKANDER
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Credential | MD
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Telephone | 310-978-8026
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A39011
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License Number State | CA
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