Healthcare Provider Details

I. General information

NPI: 1558657676
Provider Name (Legal Business Name): KARIM GALAL LOTFY MOHAMMED M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2011
Last Update Date: 12/02/2021
Certification Date: 12/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9095 RIO SAN DIEGO DR STE 250
SAN DIEGO CA
92108-1699
US

IV. Provider business mailing address

15 ILAHEE LN STE 150
CHICO CA
95973-7205
US

V. Phone/Fax

Practice location:
  • Phone: 619-272-0400
  • Fax:
Mailing address:
  • Phone: 619-272-0400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA134920
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: