Provider Demographics
NPI:1033670732
Name:AL BAGHDADI, MAHA (MD)
Entity Type:Individual
Prefix:
First Name:MAHA
Middle Name:
Last Name:AL BAGHDADI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MAHA
Other - Middle Name:ABDULRAZZAQ MAHDI
Other - Last Name:AL BAGHDADI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:700 TIVERTON AVE # 7-155
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-8361
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:700 TIVERTON AVE # 7-155
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-8361
Practice Address - Country:US
Practice Address - Phone:310-206-6741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA178879207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology