Healthcare Provider Details

I. General information

NPI: 1578786448
Provider Name (Legal Business Name): MOHAMMAD HELMY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 THE CITY DR S ROUTE 140
ORANGE CA
92868-3201
US

IV. Provider business mailing address

2572 W RUNYON PL
ANAHEIM CA
92804-2272
US

V. Phone/Fax

Practice location:
  • Phone: 714-456-5033
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License NumberA84120
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: