Organization
JACOB K AHDOOT MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB K AHDOOT MD (OWNER)
(949) 753-8882
Entity
Organization
Contact information
Practice address
15775 LAGUNA CANYON RD, SUITE 220, IRVINE, CA 92618-3145
(949) 753-8882
(949) 727-3793
Mailing address
15775 LAGUNA CANYON RD, SUITE 220, IRVINE, CA 92618-3145
(949) 753-8882
(949) 727-3793
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
A46389
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00070549
MEDICARE RAILROAD PROVIDER#
CA
Enumeration date
05/03/2007
Last updated
06/27/2014
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