Provider Demographics
NPI:1114542479
Name:ELFITURI, MAHMUD OMAR (MD)
Entity type:Individual
Prefix:MR
First Name:MAHMUD
Middle Name:OMAR
Last Name:ELFITURI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:750 WELCH RD STE 305
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1510
Mailing Address - Country:US
Mailing Address - Phone:650-721-6849
Mailing Address - Fax:650-725-8343
Practice Address - Street 1:750 WELCH RD STE 305
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1510
Practice Address - Country:US
Practice Address - Phone:650-721-6849
Practice Address - Fax:650-725-8343
Is Sole Proprietor?:No
Enumeration Date:2020-06-12
Last Update Date:2023-10-26
Deactivation Date:2022-01-18
Deactivation Code:
Reactivation Date:2022-04-06
Provider Licenses
StateLicense IDTaxonomies
CAA1855622080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology