Provider Demographics
NPI:1972351013
Name:AHMED, ABBAS MOHAMED
Entity type:Individual
Prefix:
First Name:ABBAS
Middle Name:MOHAMED
Last Name:AHMED
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9450 MIRA MESA BLVD STE C610
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-4801
Mailing Address - Country:US
Mailing Address - Phone:619-674-2845
Mailing Address - Fax:
Practice Address - Street 1:9450 MIRA MESA BLVD STE C610
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-4801
Practice Address - Country:US
Practice Address - Phone:619-674-2845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver