Provider Demographics
NPI:1467876599
Name:QADI, MOHAMUD AHMED (MD, MPH)
Entity type:Individual
Prefix:
First Name:MOHAMUD
Middle Name:AHMED
Last Name:QADI
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:MOHAMUD
Other - Middle Name:HASSAN
Other - Last Name:HAYE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1040 FLYNN RD
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-5092
Mailing Address - Country:US
Mailing Address - Phone:805-673-3930
Mailing Address - Fax:805-659-3217
Practice Address - Street 1:355 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:FILLMORE
Practice Address - State:CA
Practice Address - Zip Code:93015-1920
Practice Address - Country:US
Practice Address - Phone:805-524-4926
Practice Address - Fax:805-524-4137
Is Sole Proprietor?:No
Enumeration Date:2014-02-10
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT73603207R00000X
CT390200000X
MD390200000X
CAA187036207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program