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General NPI Number Information
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NPI Number | 1457657140
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Entity Type | Organization
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Legal Business Name | MORRIS M. AHDOOT MD INC.
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Dates
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Enumeration Date | 01/28/2011
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Last Update Date | 01/28/2011
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Provider Practice Location Address
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Address Line | 15775 LAGUNA CANYON RD
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City | IRVINE
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State | CA
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Zip | 92618-3189
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Country | US
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Telephone | 949-453-1173
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Fax | 949-453-1175
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Provider Business Mailing Address
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Address Line | 15775 LAGUNA CANYON RD STE 200
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City | IRVINE
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State | CA
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Zip | 92618-3191
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Country | US
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Telephone | 949-453-1173
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Fax | 949-453-1175
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MORRIS M AHDOOT
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Credential | MD
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Telephone | 949-453-1173
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | A67668
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License Number State | CA
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