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General NPI Number Information
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NPI Number | 1508020561
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Entity Type | Organization
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Legal Business Name | MEDHAT F. MIKHAEL, M.D., INC
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Dates
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Enumeration Date | 07/17/2008
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Last Update Date | 11/03/2022
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Provider Practice Location Address
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Address Line | 18035 BROOKHURST ST # 1200
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-6738
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Country | US
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Telephone | 714-963-7240
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Fax | 714-963-7224
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Provider Business Mailing Address
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Address Line | 16787 BEACH BLVD # 276
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-4848
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Country | US
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Telephone | 714-845-9273
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MEDHAT MIKHAEL
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Credential | M.D.
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Telephone | 562-595-0060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | A55997
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License Number State | CA
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