Provider Demographics
NPI:1881799096
Name:NAWAR, MAGDY T (MD)
Entity type:Individual
Prefix:
First Name:MAGDY
Middle Name:T
Last Name:NAWAR
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 1:26800 CROWN VALLEY PARKWAY
Mailing Address - Street 2:SUITE 485
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691
Mailing Address - Country:US
Mailing Address - Phone:949-364-5830
Mailing Address - Fax:949-364-6936
Practice Address - Street 1:26800 CROWN VALLEY PARKWAY
Practice Address - Street 2:SUITE 485
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691
Practice Address - Country:US
Practice Address - Phone:949-364-5830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA42320207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A42320Medicaid
CA00A42320Medicaid
A85782Medicare UPIN