Healthcare Provider Details

I. General information

NPI: 1851389464
Provider Name (Legal Business Name): MUHAMMAD RAHMI MOWJOOD DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2005
Last Update Date: 02/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16465 SIERRA LAKES PKWY SUITE 300
FONTANA CA
92336-1242
US

IV. Provider business mailing address

16465 SIERRA LAKES PKWY SUITE 300
FONTANA CA
92336
US

V. Phone/Fax

Practice location:
  • Phone: 909-429-2864
  • Fax: 909-429-2868
Mailing address:
  • Phone: 909-429-2864
  • Fax: 909-429-2868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A8033
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: