Provider Demographics
NPI:1114980703
Name:ALTURJUMAN, AHMAD M (MD, FACC)
Entity Type:Individual
Prefix:
First Name:AHMAD
Middle Name:M
Last Name:ALTURJUMAN
Suffix:
Gender:M
Credentials:MD, FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6780 INDIANA AVE STE 170
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-4284
Mailing Address - Country:US
Mailing Address - Phone:951-680-0909
Mailing Address - Fax:951-680-0906
Practice Address - Street 1:6780 INDIANA AVE STE 170
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-4284
Practice Address - Country:US
Practice Address - Phone:951-680-0909
Practice Address - Fax:951-680-0906
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA64941174400000X, 207RC0000X, 207UN0901X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No174400000XOther Service ProvidersSpecialist
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A649410Medicare ID - Type Unspecified
CAG01499Medicare UPIN