Provider Demographics
NPI:1114730132
Name:MUNSIFZADAH, MOHAMMED DAUD
Entity type:Individual
Prefix:MR
First Name:MOHAMMED
Middle Name:DAUD
Last Name:MUNSIFZADAH
Suffix:
Gender:
Credentials:
Other - Prefix:MR
Other - First Name:DAVID
Other - Middle Name:
Other - Last Name:MUNSIFZADAH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:265 ESSEX DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-2779
Mailing Address - Country:US
Mailing Address - Phone:925-727-5308
Mailing Address - Fax:
Practice Address - Street 1:60 GOLD CREST CT
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-6500
Practice Address - Country:US
Practice Address - Phone:925-664-6662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-31
Last Update Date:2025-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker