Provider Demographics
NPI:1730501776
Name:AWWAD, MAMDOUH A
Entity Type:Individual
Prefix:MR
First Name:MAMDOUH
Middle Name:A
Last Name:AWWAD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1390 MARKET ST
Mailing Address - Street 2:210
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-5402
Mailing Address - Country:US
Mailing Address - Phone:415-252-3927
Mailing Address - Fax:415-252-3910
Practice Address - Street 1:1390 MARKET ST
Practice Address - Street 2:210
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-5402
Practice Address - Country:US
Practice Address - Phone:415-252-3927
Practice Address - Fax:415-252-3910
Is Sole Proprietor?:No
Enumeration Date:2014-01-10
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist