Provider Demographics
NPI:1205043700
Name:PULMONARY & HOSPITALIST ASS.
Entity Type:Organization
Organization Name:PULMONARY & HOSPITALIST ASS.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASIF
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHMOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-403-0348
Mailing Address - Street 1:PO BOX 1697
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91077-1697
Mailing Address - Country:US
Mailing Address - Phone:626-403-0348
Mailing Address - Fax:626-403-0559
Practice Address - Street 1:375 HUNTINGTON DR.
Practice Address - Street 2:SUITE #E
Practice Address - City:SAN MARINO
Practice Address - State:CA
Practice Address - Zip Code:91108
Practice Address - Country:US
Practice Address - Phone:626-403-0348
Practice Address - Fax:626-403-0559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA72627207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A726270Medicaid
CA00A726270Medicaid
CA=========OtherTAX ID
CA00A726270Medicaid