Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 43182 | CA |
NPI | 1235268657 |
---|---|
Provider Name | Dr. Mohamad Hassan Kweider |
First Address | West Covina, CA 91792-1536 |
Second Address | West Covina, CA 91792-1536 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2007 |
Last Update Date | 08/07/2007 |