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NPI Code Detail

MEDICARE: DR. MOHAMED H. EL-GASIM MD

MEDICARE: DR. MOHAMED H. EL-GASIM MD
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
1208000000XPediatrics Physician36344AZ
22080A0000XPediatric Adolescent Medicine Physician36344AZ

General Provider Information

NPI Number : 1609025642
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MOHAMED H. EL-GASIM MD
Provider Business Mailing Address
First Line : PO BOX 617
Second Line :
City : SOMERTON
State : AZ
Zip : 85350-0617
Country : US
Telephone Number : 928-662-0406
Fax Number :
Provider Business Practice Location Address
First Line : 1896 E BABBIT LN
Second Line :
City : SAN LUIS
State : AZ
Zip : 85336-7820
Country : US
Telephone Number : 928-722-6112
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2008
Last Update Date : 08/13/2024

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