Provider Demographics
NPI:1720089147
Name:YAGHI, MOHAMAD J (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMAD
Middle Name:J
Last Name:YAGHI
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 1:4301 S FIGUEROA ST STE F
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90037-2671
Mailing Address - Country:US
Mailing Address - Phone:323-231-7700
Mailing Address - Fax:323-231-0799
Practice Address - Street 1:4301 S FIGUEROA ST , # F
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90037-2671
Practice Address - Country:US
Practice Address - Phone:323-231-7700
Practice Address - Fax:323-231-0799
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA54524208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics