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General NPI Number Information
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NPI Number | 1508098419
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Entity Type | Individual
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Provider Name | MOHAMMED ABO KHAMIS M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/12/2009
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Last Update Date | 06/06/2025
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Provider Practice Location Address
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Address Line | 1441 FLORIDA AVE
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City | MODESTO
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State | CA
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Zip | 95350-4404
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Country | US
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Telephone | 209-576-3525
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Fax |
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Provider Business Mailing Address
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Address Line | 570 PARKHILL DR APT.14
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City | FAIRLAWN
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State | OH
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Zip | 44333-9151
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Country | US
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Telephone | 313-701-5337
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 35. 099625
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 35. 099625
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License Number State | OH
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