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General NPI Number Information
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NPI Number | 1396281713
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Entity Type | Organization
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Legal Business Name | SAN MIGUEL URGENT CARE ANAHEIM A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 01/09/2017
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Last Update Date | 04/18/2017
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Provider Practice Location Address
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Address Line | 710 S BROOKHURST ST STE A
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City | ANAHEIM
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State | CA
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Zip | 92804-4321
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Country | US
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Telephone | 714-494-1331
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Fax | 714-494-1332
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Provider Business Mailing Address
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Address Line | 710 S BROOKHURST ST STE A
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City | ANAHEIM
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State | CA
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Zip | 92804-4321
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Country | US
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Telephone | 714-494-1331
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Fax | 714-494-1332
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MAHFOUZ MICHAEL
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Credential | M.D.
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Telephone | 714-494-1331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | A34248
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License Number State | CA
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