Provider Demographics
NPI:1922103076
Name:AHSAN, SYED F (MEDICAL DOCTOR)
Entity Type:Individual
Prefix:DR
First Name:SYED
Middle Name:F
Last Name:AHSAN
Suffix:
Gender:M
Credentials:MEDICAL DOCTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39000 BOB HOPE DR
Mailing Address - Street 2:W301
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-3221
Mailing Address - Country:US
Mailing Address - Phone:760-340-4566
Mailing Address - Fax:760-340-2481
Practice Address - Street 1:39000 BOB HOPE DR
Practice Address - Street 2:W301
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-3221
Practice Address - Country:US
Practice Address - Phone:760-340-4566
Practice Address - Fax:760-340-2481
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA83077174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH86157Medicare UPIN