Individual
DR. OMAR MENDOZA MAHMOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
10801 NATIONAL BOULEVARD, SUITE 611, LOS ANGELES, CA 90064-4170
(310) 273-4843
(310) 273-5056
Mailing address
10801 NATIONAL BOULEVARD, SUITE 611, LOS ANGELES, CA 90064-4170
(310) 273-4843
(310) 273-5056
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY24715
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GH439Y
MEDICARE ID
CA
Enumeration date
06/07/2012
Last updated
07/15/2015
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