Provider Demographics
NPI:1457547697
Name:MAHMOUD, ZAINAB (MD)
Entity Type:Individual
Prefix:
First Name:ZAINAB
Middle Name:
Last Name:MAHMOUD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4910 VAN NUYS BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-1752
Mailing Address - Country:US
Mailing Address - Phone:818-789-6622
Mailing Address - Fax:818-789-5833
Practice Address - Street 1:4910 VAN NUYS BLVD STE 102
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403
Practice Address - Country:US
Practice Address - Phone:818-789-6622
Practice Address - Fax:818-789-5833
Is Sole Proprietor?:No
Enumeration Date:2007-09-21
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA115059207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH123901Medicare UPIN