Healthcare Provider Details

I. General information

NPI: 1336056324
Provider Name (Legal Business Name): IBRAHIM MOHAMMED NAJAMUDDIN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26460 SUMMIT CIR
SANTA CLARITA CA
91350-2991
US

IV. Provider business mailing address

24056 CORTE ARIDO
VALENCIA CA
91354-1642
US

V. Phone/Fax

Practice location:
  • Phone: 661-254-6630
  • Fax:
Mailing address:
  • Phone: 219-313-6162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: