Provider Demographics
NPI:1548999584
Name:MUJAHED, MUWAFAQ A
Entity type:Individual
Prefix:
First Name:MUWAFAQ
Middle Name:A
Last Name:MUJAHED
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6277 LIDO CT
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:CA
Mailing Address - Zip Code:94560-1201
Mailing Address - Country:US
Mailing Address - Phone:650-863-3600
Mailing Address - Fax:
Practice Address - Street 1:6277 LIDO CT
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:CA
Practice Address - Zip Code:94560-1201
Practice Address - Country:US
Practice Address - Phone:650-863-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)