Provider Demographics
NPI:1235737610
Name:SIRAJ K AHMED MD INC
Entity Type:Organization
Organization Name:SIRAJ K AHMED MD INC
Other - Org Name:VALLEY HYPERBARIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / MD
Authorized Official - Prefix:
Authorized Official - First Name:SIRAJ
Authorized Official - Middle Name:K
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-823-2131
Mailing Address - Street 1:PO BOX 298
Mailing Address - Street 2:
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95336-1124
Mailing Address - Country:US
Mailing Address - Phone:209-823-2131
Mailing Address - Fax:209-823-6909
Practice Address - Street 1:520 E CENTER ST STE 102
Practice Address - Street 2:
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95336-4720
Practice Address - Country:US
Practice Address - Phone:209-823-2131
Practice Address - Fax:209-823-6909
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SIRAJ K AHMED MD INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-16
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric MedicineGroup - Multi-Specialty