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General NPI Number Information
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NPI Number | 1710242037
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Entity Type | Organization
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Legal Business Name | MAYWEST MED LLC
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Dates
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Enumeration Date | 07/12/2012
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Last Update Date | 01/17/2017
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Provider Practice Location Address
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Address Line | 24307 MAGIC MOUNTAIN PKWY # 416
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City | VALENCIA
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State | CA
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Zip | 91355-3402
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Country | US
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Telephone | 860-881-4161
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Fax |
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Provider Business Mailing Address
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Address Line | 24307 MAGIC MOUNTAIN PKWY # 416
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City | VALENCIA
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State | CA
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Zip | 91355-3402
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Country | US
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Telephone | 860-881-4161
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. MAY AWKAL
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Credential | M.D
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Telephone | 860-881-4161
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A114911
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License Number State | CA
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