Provider Demographics
NPI:1851389464
Name:MOWJOOD, MUHAMMAD RAHMI (DO)
Entity Type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:RAHMI
Last Name:MOWJOOD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16465 SIERRA LAKES PKWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336
Mailing Address - Country:US
Mailing Address - Phone:909-429-2864
Mailing Address - Fax:909-429-2868
Practice Address - Street 1:16465 SIERRA LAKES PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336-1242
Practice Address - Country:US
Practice Address - Phone:909-429-2864
Practice Address - Fax:909-429-2868
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8033207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
020A80333Medicare PIN
H71845Medicare UPIN