| Mina N Mikhail Md Inc | |
|
4500 Brockton Ave Ste 203 Riverside CA 92501-4006 | |
| (951) 750-1090 | |
| (951) 750-1091 |
| Full Name | Mina N Mikhail Md Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 4500 Brockton Ave Ste 203, Riverside, California |
| Authorized Official Name and Position | Mina N Mikhail (OWNER) |
| Authorized Official Contact | 9517501090 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mina N Mikhail Md Inc 4500 Brockton Ave Ste 203 Riverside CA 92501-4006 Ph: (951) 750-1090 | Mina N Mikhail Md Inc 4500 Brockton Ave Ste 203 Riverside CA 92501-4006 Ph: (951) 750-1090 |
| NPI Number | 1194899492 |
|---|---|
| Provider Enumeration Date | 11/20/2006 |
| Last Update Date | 04/11/2023 |
| Medicare PECOS PAC ID | 2163438128 |
|---|---|
| Medicare Enrollment ID | O20101209001240 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194899492 | NPI | - | NPPES |
| 00A513000 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A51300 (California) | Primary |
| Provider Name | Mina Mikhail |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336226786 PECOS PAC ID: 1153337118 Enrollment ID: I20070326000472 |
| Provider Name | Mousa Matar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992116982 PECOS PAC ID: 2567737026 Enrollment ID: I20210907001912 |
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