Provider Demographics
NPI:1932421559
Name:AHAD, GEORGE (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:
Last Name:AHAD
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 1:947 S ANAHEIM BLVD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-5584
Mailing Address - Country:US
Mailing Address - Phone:714-774-8870
Mailing Address - Fax:714-635-5704
Practice Address - Street 1:947 S ANAHEIM BLVD
Practice Address - Street 2:SUITE 240
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-5584
Practice Address - Country:US
Practice Address - Phone:714-774-8870
Practice Address - Fax:714-635-5704
Is Sole Proprietor?:No
Enumeration Date:2010-02-23
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA111064207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA111064Medicaid