MEDICARE: DR. MOHAMMAD KALEEM UDDIN 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	207T00000X	Neurological Surgery Physician	A83767	CA

General Provider Information

NPI Number	:	1962405142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOHAMMAD KALEEM UDDIN MD

Provider Business Mailing Address
First Line	:	36243 INLAND VALLEY DR
Second Line	:	STE 210
City	:	WILDOMAR
State	:	CA
Zip	:	92595-9549
Country	:	US
Telephone Number	:	951-677-2300
Fax Number	:	951-677-1033

Provider Business Practice Location Address
First Line	:	36243 INLAND VALLEY DR
Second Line	:	STE 210
City	:	WILDOMAR
State	:	CA
Zip	:	92595-9549
Country	:	US
Telephone Number	:	951-677-2300
Fax Number	:	951-677-1033

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	07/08/2007

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