Provider Demographics
NPI:1679069298
Name:MY MD INC
Entity type:Organization
Organization Name:MY MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:UMAR
Authorized Official - Last Name:FARUKHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-602-7615
Mailing Address - Street 1:2680 N SANTIAGO BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-1859
Mailing Address - Country:US
Mailing Address - Phone:714-602-7615
Mailing Address - Fax:714-509-1377
Practice Address - Street 1:1211 W LA PALMA AVE STE 503
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-2812
Practice Address - Country:US
Practice Address - Phone:714-602-7615
Practice Address - Fax:714-509-1377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-06
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA130994207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty