Individual
PAUL NABEEL MOGANNAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A86074
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00679808
RAILROAD MEDICARE
—
Enumeration date
04/18/2007
Last updated
04/20/2009
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