Healthcare Provider Details

I. General information

NPI: 1063119204
Provider Name (Legal Business Name): ULTIMATE ULTRASOUND, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2023
Last Update Date: 02/08/2023
Certification Date: 01/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 BALCONY
IRVINE CA
92603-4237
US

IV. Provider business mailing address

27 BALCONY
IRVINE CA
92603-4237
US

V. Phone/Fax

Practice location:
  • Phone: 949-307-6026
  • Fax:
Mailing address:
  • Phone: 949-307-6026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State

VIII. Authorized Official

Name: ADIL MAZHAR
Title or Position: CEO
Credential: MD
Phone: 949-307-6026