Individual
MUFFADAL AHMED TAHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
39000 BOB HOPE DR DEPT OF, RANCHO MIRAGE, CA 92270-3221
(760) 340-3911
Mailing address
PO BOX 280, RANCHO MIRAGE, CA 92270-0280
(805) 286-3826
(805) 221-6843
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A108439
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A1084390
BCBS OF CA
CA
05
—
0A1084390
—
CA
05
—
1265617807
—
CA
Enumeration date
01/02/2008
Last updated
04/05/2018
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