| Maged Basilios, Md Inc | |
|
4505 E Slauson Ave Suite E Maywood CA 90270-4955 | |
| (323) 771-0080 | |
| (323) 771-0090 |
| Full Name | Maged Basilios, Md Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4505 E Slauson Ave, Maywood, California |
| Authorized Official Name and Position | Maged Basilios (PRESIDENT) |
| Authorized Official Contact | 3237710080 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maged Basilios, Md Inc 4505 E Slauson Ave Suite E Maywood CA 90270-4955 Ph: (323) 771-0080 | Maged Basilios, Md Inc 4505 E Slauson Ave Suite E Maywood CA 90270-4955 Ph: (323) 771-0080 |
| NPI Number | 1326459256 |
|---|---|
| Provider Enumeration Date | 05/13/2014 |
| Last Update Date | 05/15/2014 |
| Medicare PECOS PAC ID | 2668691544 |
|---|---|
| Medicare Enrollment ID | O20140909001246 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326459256 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A061990 (California) | Primary |
| Provider Name | Maged Z Basilios |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225021462 PECOS PAC ID: 8123910841 Enrollment ID: I20040326001428 |
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