| Michel J. Mazouz, M.d., A Medical Corporation | |
|
1125 S Beverly Dr Suite 730 Los Angeles CA 90035-1148 | |
| (310) 201-0626 | |
| (310) 277-2852 |
| Full Name | Michel J. Mazouz, M.d., A Medical Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 1125 S Beverly Dr, Los Angeles, California |
| Authorized Official Name and Position | Michel J. Mazouz (PRESIDENT) |
| Authorized Official Contact | 3102010626 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michel J. Mazouz, M.d., A Medical Corporation Po Box 67218 Los Angeles CA 90067-0218 Ph: (310) 201-0626 | Michel J. Mazouz, M.d., A Medical Corporation 1125 S Beverly Dr Suite 730 Los Angeles CA 90035-1148 Ph: (310) 201-0626 |
| NPI Number | 1346395605 |
|---|---|
| Provider Enumeration Date | 01/24/2007 |
| Last Update Date | 07/14/2015 |
| Medicare PECOS PAC ID | 8527164276 |
|---|---|
| Medicare Enrollment ID | O20070426000403 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346395605 | NPI | - | NPPES |
| 00A440450 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A44045 (California) | Primary |
| Provider Name | Michel J Mazouz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679628036 PECOS PAC ID: 8628174380 Enrollment ID: I20070426000500 |
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