Individual
FRED MAH
Active
Individual
FRED MAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT6214
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DA6172
MEDICARE RAILROAD GROUP #
CA
01
—
OT0062140
BLUE SHIELD OF CA. PIN
CA
01
—
P00089881
MEDICARE RAILROAD INDIVIDUAL ID #
CA
Enumeration date
10/04/2006
Last updated
05/27/2008
Update your record
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