Provider Demographics
NPI:1922167774
Name:MICHAEL HABASHY MD A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:MICHAEL HABASHY MD A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:FAROUK
Authorized Official - Last Name:HABASHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-636-9444
Mailing Address - Street 1:1456 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91201-1214
Mailing Address - Country:US
Mailing Address - Phone:818-240-0907
Mailing Address - Fax:818-247-4887
Practice Address - Street 1:2031 W ALAMEDA AVE
Practice Address - Street 2:SUIT # 340
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-2958
Practice Address - Country:US
Practice Address - Phone:818-636-9444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty