Provider Demographics
NPI:1831068105
Name:MEELAD MOHAMMADI MD INC
Entity type:Organization
Organization Name:MEELAD MOHAMMADI MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEELAD
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMMADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-459-8152
Mailing Address - Street 1:1010 PRINCIPIA DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-1524
Mailing Address - Country:US
Mailing Address - Phone:312-459-8152
Mailing Address - Fax:
Practice Address - Street 1:1010 PRINCIPIA DR
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-1524
Practice Address - Country:US
Practice Address - Phone:312-459-8152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-04
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty