Healthcare Provider Details

I. General information

NPI: 1902945926
Provider Name (Legal Business Name): ZAIN VALLY-MAHOMED MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82 PUUHONU PL STE 202-203
HILO HI
96720-2010
US

IV. Provider business mailing address

14691 SERON AVE
IRVINE CA
92606-2129
US

V. Phone/Fax

Practice location:
  • Phone: 808-935-6353
  • Fax:
Mailing address:
  • Phone: 949-302-3636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberMD-15396
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA107041
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD-15396
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: