Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | N8216 | TX |
N | 111NI0900X | Internist | N8216 | TX |
N | 207RC0000X | Internist - Cardiovascular Disease | N8216 | TX |
Y | 207RI0011X | Interventional Cardiology | A151218 | CA |
N | 207RI0011X | Interventional Cardiology | N8216 | TX |
NPI | 1083868145 |
---|---|
Provider Name | Dr. Mohammad Madjid |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Ventura, CA 93003-5569 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2008 |
Last Update Date | 24/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
280707503 | (05) | TX |