Provider Demographics
NPI:1255478418
Name:MIKHAIL MORCOS, MOURAD RAMZI (DDS)
Entity Type:Individual
Prefix:DR
First Name:MOURAD
Middle Name:RAMZI
Last Name:MIKHAIL MORCOS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 E. ALVIN DR. SUITE J2
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93906
Mailing Address - Country:US
Mailing Address - Phone:831-771-0198
Mailing Address - Fax:831-771-1690
Practice Address - Street 1:631 E. ALVIN DR. SUITE J2
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906
Practice Address - Country:US
Practice Address - Phone:831-771-0198
Practice Address - Fax:831-771-1690
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44943122300000X, 1223G0001X
CAD44943122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB44943-01Medicaid