Provider Demographics
NPI:1518998723
Name:DRS. MISHAL, PHAM & ASSOCIATES
Entity Type:Organization
Organization Name:DRS. MISHAL, PHAM & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DEVADATT
Authorized Official - Middle Name:MADHUKAR
Authorized Official - Last Name:MISHAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-869-4579
Mailing Address - Street 1:8500 FLORENCE AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90240-4054
Mailing Address - Country:US
Mailing Address - Phone:562-869-4579
Mailing Address - Fax:562-862-1765
Practice Address - Street 1:8500 FLORENCE AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-4054
Practice Address - Country:US
Practice Address - Phone:562-869-4579
Practice Address - Fax:562-862-1765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA36594207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0082351OtherGROUP MEDICAL RENDERING NUMBER
CAGR0082351OtherGROUP MEDICAL RENDERING NUMBER
CA00A365940OtherMEDICAL RENDERING PROVIDER NUMBER
CA00AX85240OtherMEDICAL RENDERING PROVIDER NUMBER
CAPA13910OtherPHYSICIAN ASSISTANT RENDERING PROVIDER NUMBER
CAW13887Medicare PIN
CA00G788100OtherMEDICAL RENDERING PROVIDER NUMBER
CA00G792850OtherMEDICAL RENDERING PROVIDER NUMBER