Provider Demographics
NPI:1407340763
Name:ATTRAH, AHMED (NEMT PROVIDER)
Entity Type:Individual
Prefix:MR
First Name:AHMED
Middle Name:
Last Name:ATTRAH
Suffix:
Gender:M
Credentials:NEMT PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 GIOTTO
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-8574
Mailing Address - Country:US
Mailing Address - Phone:714-909-5000
Mailing Address - Fax:
Practice Address - Street 1:1438 S EUCLID ST
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92802-2103
Practice Address - Country:US
Practice Address - Phone:714-909-5000
Practice Address - Fax:714-333-4412
Is Sole Proprietor?:No
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor