Provider Demographics
NPI:1477836393
Name:MIKHAEL, ABRAAM ALFY
Entity Type:Individual
Prefix:
First Name:ABRAAM
Middle Name:ALFY
Last Name:MIKHAEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6860 WINTERBERRY WAY
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92880-8951
Mailing Address - Country:US
Mailing Address - Phone:909-348-3924
Mailing Address - Fax:
Practice Address - Street 1:6860 WINTERBERRY WAY
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92880-8951
Practice Address - Country:US
Practice Address - Phone:909-348-3924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program