Organization
MAHMOUD A. KREIDIE
Active
Other names
Neurology Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE KREIDIE M.D. (OWNER)
(949) 348-8880
Entity
Organization
Contact information
Practice address
26932 OSO PKWY, SUITE 240, MISSION VIEJO, CA 92691-5815
(949) 348-8880
Mailing address
26932 OSO PKWY, SUITE 240, MISSION VIEJO, CA 92691-5815
(949) 348-8880
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
A29528
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A295280
—
CA
01
—
ZZZ62117Z
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
04/10/2007
Last updated
06/20/2008
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