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General NPI Number Information
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NPI Number | 1649795360
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Entity Type | Organization
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Legal Business Name | ISAM MAWAS MD INC
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Dates
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Enumeration Date | 08/03/2017
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Last Update Date | 08/13/2022
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Provider Practice Location Address
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Address Line | 3831 HUGHES AVE STE 604
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City | CULVER CITY
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State | CA
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Zip | 90232-6848
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Country | US
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Telephone | 310-730-8606
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Fax | 318-973-2420
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Provider Business Mailing Address
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Address Line | 3831 HUGHES AVE STE 604
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City | CULVER CITY
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State | CA
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Zip | 90232-6848
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Country | US
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Telephone | 310-730-8606
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Fax | 318-973-2420
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ISAM MAWAS
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Credential | MD
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Telephone | 818-859-4486
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | A98516
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License Number State | CA
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