Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 4301109872 | MI |
Y | 207Q00000X | Family Doctor | A168887 | CA |
NPI | 1003265745 |
---|---|
Provider Name | Robina Ahmad |
First Address | San Diego, CA 92111-6342 |
Second Address | San Diego, CA 92111-6342 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2016 |
Last Update Date | 31/07/2021 |