Provider Demographics
NPI:1134193923
Name:AHMED, KHALID B (MD)
Entity type:Individual
Prefix:DR
First Name:KHALID
Middle Name:B
Last Name:AHMED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4511 ROSEMEAD BLVD
Mailing Address - Street 2:
Mailing Address - City:PICO RIVERA
Mailing Address - State:CA
Mailing Address - Zip Code:90660-2032
Mailing Address - Country:US
Mailing Address - Phone:562-695-2282
Mailing Address - Fax:562-695-7252
Practice Address - Street 1:4511 ROSEMEAD BLVD
Practice Address - Street 2:
Practice Address - City:PICO RIVERA
Practice Address - State:CA
Practice Address - Zip Code:90660-2032
Practice Address - Country:US
Practice Address - Phone:562-695-2282
Practice Address - Fax:562-695-7252
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA33354207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA33354DMedicare ID - Type Unspecified
CAA27124Medicare UPIN