Individual
DR. MUSTAFA MAHDAVY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1117 E. DEVONSHIRE AVE. DEPARTMENT OF PATHOLOGY, HEMET, CA 92543
(985) 789-7994
(951) 765-4829
Mailing address
1117 E. DEVONSHIRE AVE. DEPARTMENT OF PATHOLOGY, HEMET, CA 92543
(985) 789-7994
(951) 765-4829
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
A93215
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1074730
—
LA
Enumeration date
10/06/2006
Last updated
07/09/2007
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