Individual
FAKIRMOHMED MAHMED GOSLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15 VACAVILLE, IRVINE, CA 92602
(714) 389-2535
Mailing address
PO BOX 60265, 15 VACAVILLE, IRVINE, CA 92602
(714) 389-2535
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
AFE33960
CA
208D00000X
General Practice Physician
AFE33960
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3864816
—
CA
Enumeration date
03/18/2008
Last updated
03/18/2008
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