Healthcare Provider Details

I. General information

NPI: 1558363168
Provider Name (Legal Business Name): MUSTAFA AMMAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 SUTTER ST
YUBA CITY CA
95991-3459
US

IV. Provider business mailing address

PO BOX A D
YUBA CITY CA
95992-1396
US

V. Phone/Fax

Practice location:
  • Phone: 530-673-9420
  • Fax: 530-673-9451
Mailing address:
  • Phone: 530-751-3769
  • Fax: 530-751-1237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA52256
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA52256
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: