Provider Demographics
NPI:1700145596
Name:SEENA MEDICAL INC
Entity Type:Organization
Organization Name:SEENA MEDICAL INC
Other - Org Name:DAVID MOHAMADI M.D.
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-988-5999
Mailing Address - Street 1:14624 SHERMAN WAY STE 406
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-2288
Mailing Address - Country:US
Mailing Address - Phone:818-988-5999
Mailing Address - Fax:818-988-5005
Practice Address - Street 1:14624 SHERMAN WAY STE 406
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-2288
Practice Address - Country:US
Practice Address - Phone:818-988-5999
Practice Address - Fax:818-988-5005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-14
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA054775207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A547750Medicaid
A54775OtherMEDICARE ID-TYPE UNSPECIFIED
CA00A547750Medicaid