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General NPI Number Information
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NPI Number | 1346440500
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Entity Type | Organization
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Legal Business Name | AHMED MEDICAL CORPORATION
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Dates
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Enumeration Date | 07/24/2007
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Last Update Date | 07/24/2007
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Provider Practice Location Address
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Address Line | 15201 11TH ST STE 400
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City | VICTORVILLE
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State | CA
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Zip | 92395-3735
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Country | US
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Telephone | 760-955-7095
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Fax | 760-951-1076
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Provider Business Mailing Address
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Address Line | 15201 11TH ST STE 400
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City | VICTORVILLE
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State | CA
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Zip | 92395-3735
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Country | US
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Telephone | 760-955-7095
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Fax | 760-951-1076
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Authorized Official
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Title or Position | OWNER
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Name | KELLY AHMED
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Credential | MD
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Telephone | 760-956-1095
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | A51617
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A51407
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License Number State | CA
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