Provider Demographics
NPI:1790212033
Name:HARARAH, MAHMOUD
Entity type:Individual
Prefix:MR
First Name:MAHMOUD
Middle Name:
Last Name:HARARAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33863 JULIET CIR
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94555-3453
Mailing Address - Country:US
Mailing Address - Phone:510-509-5747
Mailing Address - Fax:
Practice Address - Street 1:33863 JULIET CIR
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94555-3453
Practice Address - Country:US
Practice Address - Phone:510-509-5747
Practice Address - Fax:510-676-9487
Is Sole Proprietor?:No
Enumeration Date:2017-05-17
Last Update Date:2017-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver