Provider Demographics
NPI:1508020561
Name:MEDHAT F. MIKHAEL, M.D., INC
Entity Type:Organization
Organization Name:MEDHAT F. MIKHAEL, M.D., INC
Other - Org Name:PAIN MEDICINE ASSOCIATES, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MEDHAT
Authorized Official - Middle Name:
Authorized Official - Last Name:MIKHAEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-595-0060
Mailing Address - Street 1:16787 BEACH BLVD # 276
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-4848
Mailing Address - Country:US
Mailing Address - Phone:714-845-9273
Mailing Address - Fax:
Practice Address - Street 1:18035 BROOKHURST ST # 1200
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-6738
Practice Address - Country:US
Practice Address - Phone:714-963-7240
Practice Address - Fax:714-963-7224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-17
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA55997208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA005599700OtherMEDI-CAL
CA00A55970Medicaid
CAW19786Medicare UPIN
CAWA55997EMedicare PIN
CA00A55970Medicaid