Provider Demographics
NPI:1386208304
Name:AHMED, DANIYAL AFAQ (PA-C, MPH)
Entity type:Individual
Prefix:
First Name:DANIYAL
Middle Name:AFAQ
Last Name:AHMED
Suffix:
Gender:M
Credentials:PA-C, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1091 S LA BREA AVE
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90301-3817
Mailing Address - Country:US
Mailing Address - Phone:310-392-8636
Mailing Address - Fax:310-943-3521
Practice Address - Street 1:1091 S LA BREA AVE
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-3817
Practice Address - Country:US
Practice Address - Phone:310-392-8636
Practice Address - Fax:310-943-3521
Is Sole Proprietor?:No
Enumeration Date:2019-04-24
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57361363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant