Provider Demographics
NPI:1932188521
Name:AHMED, SYED SAJEEL (MD)
Entity Type:Individual
Prefix:DR
First Name:SYED
Middle Name:SAJEEL
Last Name:AHMED
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 1:525 COMMERCE AVE STE A
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-4487
Mailing Address - Country:US
Mailing Address - Phone:661-945-8717
Mailing Address - Fax:661-945-4867
Practice Address - Street 1:525 COMMERCE AVE STE A
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-4487
Practice Address - Country:US
Practice Address - Phone:661-945-8717
Practice Address - Fax:661-945-4867
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA87434174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI28571Medicare UPIN
CAWA87434AMedicare ID - Type Unspecified