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NPI Code Detail

MEDICARE: MAHMOUD H DAHER D.P.T

MEDICARE: MAHMOUD H DAHER D.P.T
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT 39920CA

General Provider Information

NPI Number : 1316289390
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAHMOUD H DAHER D.P.T
Provider Business Mailing Address
First Line : 2000 GARDEN RD
Second Line :
City : MONTEREY
State : CA
Zip : 93940-5313
Country : US
Telephone Number : 831-375-1885
Fax Number : 831-375-7436
Provider Business Practice Location Address
First Line : 5910 PACIFIC AVE
Second Line :
City : STOCKTON
State : CA
Zip : 95207-4704
Country : US
Telephone Number : 209-475-1000
Fax Number : 209-475-1000
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2013
Last Update Date : 06/26/2013

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