Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 49104 | TN |
Y | 2080P0208X | Pediatric Infectious Diseases | A135708 | CA |
NPI | 1124258025 |
---|---|
Provider Name | Mohammad Nael Mhaissen |
First Address | Madera, CA 93636-8761 |
Second Address | Madera, CA 93636-8761 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2009 |
Last Update Date | 07/08/2015 |