MEDICARE: DR. MOHSIN MAHMOOD D.D.S

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
1	1223G0001X	General Practice Dentistry	52424	CA

General Provider Information

NPI Number	:	1699978999
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOHSIN MAHMOOD D.D.S

Provider Business Mailing Address
First Line	:	24902 MOULTON PKWY STE 100
Second Line	:
City	:	LAGUNA WOODS
State	:	CA
Zip	:	92637-6403
Country	:	US
Telephone Number	:	949-619-4162
Fax Number	:	949-215-1126

Provider Business Practice Location Address
First Line	:	24102 EL TORO RD
Second Line	:	SUITE A
City	:	LAGUNA WOODS
State	:	CA
Zip	:	92637-3123
Country	:	US
Telephone Number	:	949-830-6510
Fax Number	:	949-472-4073

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2007
Last Update Date	:	03/03/2021

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