Provider Demographics
NPI:1902973472
Name:MOHAMMAD, AHMAD SHAH (MD)
Entity Type:Individual
Prefix:DR
First Name:AHMAD SHAH
Middle Name:
Last Name:MOHAMMAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8851 CENTER DR STE 307
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-6006
Mailing Address - Country:US
Mailing Address - Phone:619-337-7900
Mailing Address - Fax:619-337-7902
Practice Address - Street 1:8851 CENTER DR STE 307
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-6006
Practice Address - Country:US
Practice Address - Phone:619-337-7900
Practice Address - Fax:619-337-7902
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA988312084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology