Basic Information
| Provider Information | |||||||||
| NPI: | 1801390596 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MIKHAEL | ||||||||
| FirstName: | MARINA | ||||||||
| MiddleName: | MAGDI | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 757 WESTWOOD PLAZA | ||||||||
| Address2: | ANESTHESIA | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900957419 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3102678654 | ||||||||
| FaxNumber: | 3102673766 | ||||||||
| Practice Location | |||||||||
| Address1: | 757 WESTWOOD PLAZA | ||||||||
| Address2: | ANESTHESIA | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900957419 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3102678654 | ||||||||
| FaxNumber: | 3102673766 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/19/2018 | ||||||||
| LastUpdateDate: | 06/15/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | A165171 | CA | Y | Allopathic & Osteopathic Physicians | Anesthesiology | 390200000X | CA | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.