Provider Demographics
NPI:1699846352
Name:MOHAMED, KARIM IBRAHIM (MD)
Entity Type:Individual
Prefix:
First Name:KARIM
Middle Name:IBRAHIM
Last Name:MOHAMED
Suffix:
Gender:M
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:PO BOX 62106
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93160-2106
Mailing Address - Country:US
Mailing Address - Phone:805-737-8760
Mailing Address - Fax:805-737-8760
Practice Address - Street 1:1225 N H ST
Practice Address - Street 2:
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-3301
Practice Address - Country:US
Practice Address - Phone:805-737-8760
Practice Address - Fax:805-737-8760
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA76701208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH78470Medicare UPIN
CACT686ZMedicare PIN