Individual
AHMAD MOEIN MASHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9412 BIG HORN BLVD STE 6, ELK GROVE, CA 95758-1101
(916) 893-6606
Mailing address
9412 BIG HORN BLVD STE 6, ELK GROVE, CA 95758-1101
(916) 893-6606
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95127467A
MEDI-CAL
CA
Enumeration date
07/24/2018
Last updated
07/24/2018
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