Healthcare Provider Details

I. General information

NPI: 1932188521
Provider Name (Legal Business Name): SYED SAJEEL AHMED M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2006
Last Update Date: 02/28/2023
Certification Date: 02/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 COMMERCE AVE STE A
PALMDALE CA
93551-4487
US

IV. Provider business mailing address

525 COMMERCE AVE STE A
PALMDALE CA
93551-4487
US

V. Phone/Fax

Practice location:
  • Phone: 661-945-8717
  • Fax: 661-945-4867
Mailing address:
  • Phone: 661-945-8717
  • Fax: 661-945-4867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA87434
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: