Individual
DR. EHTISHAM MAHMUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103
(858) 657-8530
(858) 657-8021
Mailing address
PO BOX 232410, SAN DIEGO, CA 92193-2410
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
G75925
CA
207RI0011X
Interventional Cardiology Physician
Primary
G75925
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G759250
—
CA
Enumeration date
07/08/2006
Last updated
05/23/2018
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