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General NPI Number Information
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NPI Number | 1437372638
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Entity Type | Organization
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Legal Business Name | MABUHAY MEDICAL GROUP
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 16030 VENTURA BLVD STE 200
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City | ENCINO
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State | CA
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Zip | 91436-2754
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Country | US
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Telephone | 818-461-5030
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Fax | 818-461-5095
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Provider Business Mailing Address
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Address Line | 16030 VENTURA BLVD STE 200
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City | ENCINO
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State | CA
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Zip | 91436-2754
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Country | US
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Telephone | 818-461-5030
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Fax | 818-461-5095
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Authorized Official
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Title or Position | GROUP PRESIDENT
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Name | DR. THELMA LAMORENA
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Credential | M.D.
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Telephone | 818-461-5030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | A29376
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License Number State | CA
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