Provider Demographics
NPI:1730323809
Name:M A HAMED M D INC
Entity Type:Organization
Organization Name:M A HAMED M D INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-662-7764
Mailing Address - Street 1:5265 FOUNTAIN AVE
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-1300
Mailing Address - Country:US
Mailing Address - Phone:323-662-7764
Mailing Address - Fax:323-662-7714
Practice Address - Street 1:5265 FOUNTAIN AVE
Practice Address - Street 2:SUITE 1A
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-1300
Practice Address - Country:US
Practice Address - Phone:323-662-7764
Practice Address - Fax:323-662-7714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-21
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA32084207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABP870AMedicare PIN