Provider Demographics
NPI:1598533648
Name:MOHAMED, EMMAN
Entity Type:Individual
Prefix:
First Name:EMMAN
Middle Name:
Last Name:MOHAMED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 S 45TH ST APT 5
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94804-4457
Mailing Address - Country:US
Mailing Address - Phone:510-480-5032
Mailing Address - Fax:
Practice Address - Street 1:855 S 45TH ST APT 5
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94804-4457
Practice Address - Country:US
Practice Address - Phone:510-480-5032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider