Provider Demographics
NPI:1477555811
Name:MAHMOOD, SAIMA (MD)
Entity Type:Individual
Prefix:
First Name:SAIMA
Middle Name:
Last Name:MAHMOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5618 GOLD CREEK DR
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94552-5440
Mailing Address - Country:US
Mailing Address - Phone:256-473-9788
Mailing Address - Fax:
Practice Address - Street 1:5618 GOLD CREEK DR
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94552-5440
Practice Address - Country:US
Practice Address - Phone:256-473-9788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-15
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11547207R00000X
CAA122980207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100506515Medicaid
NV100506515Medicaid