Provider Demographics
NPI:1235428319
Name:MOHAMMED FAIZ AHMED M.D. APC
Entity Type:Organization
Organization Name:MOHAMMED FAIZ AHMED M.D. APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT M.D.
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:FAIZ
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-241-4210
Mailing Address - Street 1:360 S CLOVER AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-5118
Mailing Address - Country:US
Mailing Address - Phone:408-241-4210
Mailing Address - Fax:408-241-4417
Practice Address - Street 1:360 S CLOVER AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-5118
Practice Address - Country:US
Practice Address - Phone:408-241-4210
Practice Address - Fax:408-241-4417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-29
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA503142084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6686730001Medicare NSC