MEDICARE: FOUR M MEDICAL MART A MEDICAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2083X0100X	Occupational Medicine Physician

General Provider Information

NPI Number	:	1447381736
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOUR M MEDICAL MART A MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	PO BOX 291040
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90029-9040
Country	:	US
Telephone Number	:	818-994-0804
Fax Number	:	818-994-4117

Provider Business Practice Location Address
First Line	:	11432 VANOWEN STREET
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91605-6220
Country	:	US
Telephone Number	:	818-503-9999
Fax Number	:	818-503-0675

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	MAHFOUZ M MICHAEL
Credential	:	MD
Telephone Number	:	818-994-0804

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	08/22/2020

Similar Medicare Providers

1740481241 — MAJESTIC HOME HEALTH CARE, INC.
Practice Location Address:

11434 VANOWEN ST
NORTH HOLLYWOOD, CA
91605-6220

Practice Phone: 818-392-7900
Practice Fax: 818-392-7611

1003438839 — PRIMARY HEALTHCARE SOLUTIONS
Practice Location Address:

11436 VANOWEN ST STE A
NORTH HOLLYWOOD, CA
91605-6220

Practice Phone: 310-666-2392
Practice Fax: 818-484-2919

1710259726 — YEONJUNG KIM
Practice Location Address:

6220 MORELLA AVE
NORTH HOLLYWOOD, CA
91606

Practice Phone: 213-700-8542
Practice Fax:

1033173737 — DR. MARK FOSTER HANSEN M.D.
Practice Location Address:

14215 NORTH 2ND AVENUE
PHOENIX, AZ
85023-6220

Practice Phone: 602-564-1346
Practice Fax:

1497946867 — MRS. CATHY SHIEL-REARDON MA
Practice Location Address:

6220 NORTH PAULINA
CHICAGO, IL
60660-1119

Practice Phone: 773-465-8658
Practice Fax:

1831437904 — KEONA PATRICE SCOTT
Practice Location Address:

6220 TRINITY RIVER CT
NORTH LAS VEGAS, NV
89081-6651

Practice Phone: 702-689-8658
Practice Fax:

Directions to “FOUR M MEDICAL MART A MEDICAL CORPORATION ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.