Provider Demographics
NPI:1235990060
Name:JAMAL MUJADDID MOHAMMED, M.D., INC.
Entity Type:Organization
Organization Name:JAMAL MUJADDID MOHAMMED, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMAL MUJADDID
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-793-0947
Mailing Address - Street 1:412 HERKIMER ST APT 7E
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-1629
Mailing Address - Country:US
Mailing Address - Phone:832-488-5529
Mailing Address - Fax:
Practice Address - Street 1:8909 BRECON WAY
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-5202
Practice Address - Country:US
Practice Address - Phone:916-793-0947
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS1201XAllopathic & Osteopathic PhysiciansFamily MedicineSleep MedicineGroup - Multi-Specialty