Individual
AHMED MOHAMED MAHDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
12730 HEACOCK ST STE 4A, MORENO VALLEY, CA 92553-3040
(951) 243-8517
Mailing address
3640 WILSHIRE BLVD APT 317, LOS ANGELES, CA 90010-2645
(256) 348-5521
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
95009179
CA
363LA2200X
Adult Health Nurse Practitioner
Primary
95009179
CA
363LG0600X
Gerontology Nurse Practitioner
95009179
CA
363LX0106X
Occupational Health Nurse Practitioner
95009179
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95009179
CALIFORNIA STATE NURSE PRACTITIONER
CA
Enumeration date
09/11/2018
Last updated
03/07/2023
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