MEDICARE: DR. SAMIR ABED AHMAD M.D

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	207R00000X	Internal Medicine Physician	A81614	CA
2	207R00000X	Internal Medicine Physician	ME146737	FL
3	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	K9475	TX

General Provider Information

NPI Number	:	1497710545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMIR ABED AHMAD M.D

Provider Business Mailing Address
First Line	:	27800 MEDICAL CENTER RD STE 109
Second Line	:
City	:	MISSION VIEJO
State	:	CA
Zip	:	92691-6410
Country	:	US
Telephone Number	:	949-866-3600
Fax Number	:	949-221-3537

Provider Business Practice Location Address
First Line	:	27800 MEDICAL CENTER RD STE 109
Second Line	:
City	:	MISSION VIEJO
State	:	CA
Zip	:	92691-6410
Country	:	US
Telephone Number	:	949-866-3600
Fax Number	:	949-221-3537

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

Provider Enumeration Date	:	04/20/2006
Last Update Date	:	05/01/2024

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