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Individual

DR. MASSOUD MAHMOUDI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
812 POLLARD RD, SUITE 5, LOS GATOS, CA 95032-1420
(408) 866-6885
Mailing address
812 POLLARD RD, SUITE 5, LOS GATOS, CA 95032-1420
(408) 866-6885

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
20A7157
CA
207R00000X
Internal Medicine Physician
20A7157
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0020A71570
CA
Enumeration date
11/10/2006
Last updated
01/19/2010
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