MEDICARE: MOHAMMAD ISMAIL MD

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	207RN0300X	Nephrology Physician	A45544	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	W20647	OTHER		MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730105784
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHAMMAD ISMAIL MD

Provider Business Mailing Address
First Line	:	16415 COLORADO AVE
Second Line	:	SUITE 207
City	:	PARAMOUNT
State	:	CA
Zip	:	90723-5035
Country	:	US
Telephone Number	:	562-602-2334
Fax Number	:	562-602-0931

Provider Business Practice Location Address
First Line	:	16415 COLORADO AVE
Second Line	:	SUITE 207
City	:	PARAMOUNT
State	:	CA
Zip	:	90723-5035
Country	:	US
Telephone Number	:	562-602-2334
Fax Number	:	562-602-0931

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

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	08/11/2023

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Directions to “ MOHAMMAD ISMAIL MD” Practice Location

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