Provider Demographics
NPI:1770593105
Name:AHMED, MOHAMMED HABEEB (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:HABEEB
Last Name:AHMED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:200 JOSE FIGUERES AVE
Mailing Address - Street 2:SUITE 325
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1500
Mailing Address - Country:US
Mailing Address - Phone:408-937-9000
Mailing Address - Fax:408-937-9002
Practice Address - Street 1:200 JOSE FIGUERES AVE
Practice Address - Street 2:SUITE 325
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1500
Practice Address - Country:US
Practice Address - Phone:408-937-9000
Practice Address - Fax:408-937-9002
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA69198207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA69198OtherSTATE LICENSE
H29223Medicare UPIN
CA00A691980Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER