Provider Demographics
NPI:1942294038
Name:AHMADI, ADAM Z (MD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:Z
Last Name:AHMADI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:35800 BOB HOPE DR STE 225
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-1740
Mailing Address - Country:US
Mailing Address - Phone:760-459-2747
Mailing Address - Fax:760-770-5893
Practice Address - Street 1:35800 BOB HOPE DR STE 225
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-1740
Practice Address - Country:US
Practice Address - Phone:760-459-2747
Practice Address - Fax:760-770-5893
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2005-0295207W00000X
CAA89874207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM009V89OtherBLUE CROSS/BLUE SHEILD
NM10020029OtherCIGNA/LOVELACE
NM343522801Medicare ID - Type Unspecified
I36759Medicare UPIN