Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | A109192 | CA |
N | 208D00000X | General Practice Physician | A109192 | CA |
NPI | 1013150317 |
---|---|
Provider Name | Dr. Nader A. Ahmad |
First Address | Huntington Beach, CA 92605-3238 |
Second Address | Mission Viejo, CA 92691-3940 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2009 |
Last Update Date | 23/04/2016 |