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General NPI Number Information
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NPI Number | 1669978110
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Entity Type | Organization
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Legal Business Name | MOHSIN MAHMOOD DDS INC
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Dates
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Enumeration Date | 04/03/2018
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 24902 MOULTON PKWY STE 200
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City | LAGUNA WOODS
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State | CA
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Zip | 92637-6403
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Country | US
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Telephone | 949-619-4162
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Fax | 949-619-4162
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Provider Business Mailing Address
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Address Line | 24902 MOULTON PKWY STE 200
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City | LAGUNA WOODS
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State | CA
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Zip | 92637-6403
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Country | US
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Telephone | 949-619-4162
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. MOHSIN RAZA MAHMOOD
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Credential | DDS
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Telephone | 714-588-6004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 52424
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License Number State | CA
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