Provider Demographics
NPI:1700821329
Name:GINDI, MAGDI (MD)
Entity Type:Individual
Prefix:
First Name:MAGDI
Middle Name:
Last Name:GINDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 N WESTERN AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-1088
Mailing Address - Country:US
Mailing Address - Phone:323-463-6881
Mailing Address - Fax:323-463-6831
Practice Address - Street 1:1110 N WESTERN AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-1088
Practice Address - Country:US
Practice Address - Phone:323-463-6881
Practice Address - Fax:323-463-6831
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA31902207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ83783ZMedicaid
CAWA31902AMedicare ID - Type Unspecified
CAC35276Medicare UPIN