Provider Demographics
NPI:1538917083
Name:MOHAMED, MOHAMED HAIDER AHMED (MBBS)
Entity type:Individual
Prefix:
First Name:MOHAMED
Middle Name:HAIDER AHMED
Last Name:MOHAMED
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:MOHAMED
Other - Middle Name:HAIDER AHMED
Other - Last Name:MOHAMED
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MBBS
Mailing Address - Street 1:39000 BOB HOPE DRIVE EISENHOWER MEDICAL CENTER
Mailing Address - Street 2:AHSB, SUITE #201
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270
Mailing Address - Country:US
Mailing Address - Phone:760-340-3911
Mailing Address - Fax:760-837-8581
Practice Address - Street 1:39000 BOB HOPE DRIVE EISENHOWER MEDICAL CENTER
Practice Address - Street 2:AHSB, SUITE #201
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270
Practice Address - Country:US
Practice Address - Phone:760-340-3911
Practice Address - Fax:760-837-8581
Is Sole Proprietor?:No
Enumeration Date:2024-05-09
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program