Provider Demographics
NPI:1376199836
Name:MAHMOOD, FURYAL (MS, LCGC)
Entity Type:Individual
Prefix:
First Name:FURYAL
Middle Name:
Last Name:MAHMOOD
Suffix:
Gender:F
Credentials:MS, LCGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3505 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-5714
Mailing Address - Country:US
Mailing Address - Phone:510-752-6298
Mailing Address - Fax:
Practice Address - Street 1:3505 BROADWAY
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-5714
Practice Address - Country:US
Practice Address - Phone:510-752-6298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-12
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS