MGM PHYSICIAN ASSISTANT INC
NPI 1023871779
Physician Assistant - Surgical in Riverside, CA

Q: What is Mgm Physician Assistant Inc's NPI number?

The NPI number for Mgm Physician Assistant Inc is 1023871779. It was assigned to this organization in the NPPES registry on February 5, 2024. The provider is doing business as La Casa Wound Specialist.

Q: What is Mgm Physician Assistant Inc's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Active since February 05, 2024

1525 3RD ST STE 205, RIVERSIDE, CA 92507(310) 810-6554 Get Directions Write a Review

NPPES record last updated: December 3, 2025. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Dec 3, 2025, Feb 5, 2024 (2 updates tracked since 2024).

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About Mgm Physician Assistant Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MGM PHYSICIAN ASSISTANT INC (NPI 1023871779), doing business as La Casa Wound Specialist, is a healthcare organization registered as a surgical in Riverside, California and active in the NPI registry since February 2024. The organization lists Gina Habeeb, Ceo, as its authorized official.

NPPES Registry Identity

NPI1023871779

Entity TypeOrganization

Primary Taxonomy363AS0400X

Legal Business NameMGM PHYSICIAN ASSISTANT INC

Location Address1525 3RD ST STE 205Riverside, CA 92507-9000

Mailing Address1525 3rd St Ste 205Riverside, CA 92507-9000

Phone(310) 810-6554

Organization SubpartNo

Authorized OfficialGina HabeebCeo · (951) 788-2224

Enumeration DateFebruary 5, 2024

Last NPPES UpdateDecember 3, 20252 updates tracked since enumeration

NPPES CertifiedDecember 3, 2025

✔ NPI 1023871779 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

1525 3RD ST STE 205, Riverside, CA 92507

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Other Names 1

Doing Business AsLa Casa Wound Specialist

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mgm Physician Assistant Inc's NPI number?

The NPI number for Mgm Physician Assistant Inc is 1023871779. It was assigned to this organization in the NPPES registry on February 5, 2024. The provider is doing business as La Casa Wound Specialist.

Where is Mgm Physician Assistant Inc located?

Mgm Physician Assistant Inc is located at 1525 3rd St Ste 205, Riverside, CA 92507. The listed phone number is (310) 810-6554.

What is Mgm Physician Assistant Inc's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

When was this NPI record last updated?

The NPPES record for Mgm Physician Assistant Inc was last updated on December 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.