MEDICARE: MAI MOHSEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	69105	CA

General Provider Information

NPI Number	:	1033546544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAI MOHSEN

Provider Business Mailing Address
First Line	:	330 CRESCENT VILLAGE CIR UNIT 2321
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95134-3557
Country	:	US
Telephone Number	:	408-646-6723
Fax Number	:

Provider Business Practice Location Address
First Line	:	11450 SAN PABLO AVE
Second Line	:
City	:	EL CERRITO
State	:	CA
Zip	:	94530-1917
Country	:	US
Telephone Number	:	510-233-8400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2013
Last Update Date	:	09/28/2013

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Directions to “ MAI MOHSEN ” Practice Location

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