Provider Demographics
NPI:1649371832
Name:MAHMOOD, ASIF (MD)
Entity type:Individual
Prefix:DR
First Name:ASIF
Middle Name:
Last Name:MAHMOOD
Suffix:
Gender:M
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:PO BOX 1697
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91077-1697
Mailing Address - Country:US
Mailing Address - Phone:626-578-0283
Mailing Address - Fax:626-578-9416
Practice Address - Street 1:375 HUNTINGTON DR
Practice Address - Street 2:E
Practice Address - City:SAN MARINO
Practice Address - State:CA
Practice Address - Zip Code:91108-2357
Practice Address - Country:US
Practice Address - Phone:626-578-0283
Practice Address - Fax:626-578-9416
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA72627207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A726270Medicaid
CA00A726270Medicaid
CAA72627Medicare PIN
CAA72627Medicare ID - Type Unspecified