| Mahmoud Ajang M.d., A Professional Medical Corporation | |
|
378 W 6th St San Pedro CA 90731-3338 | |
| (310) 547-1801 | |
| (310) 547-3015 |
| Full Name | Mahmoud Ajang M.d., A Professional Medical Corporation |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 378 W 6th St, San Pedro, California |
| Authorized Official Name and Position | Mahmoud Ajang (PRESIDENT) |
| Authorized Official Contact | 3105472882 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mahmoud Ajang M.d., A Professional Medical Corporation 3466 Hightide Dr Rancho Palos Verdes CA 90275-6131 Ph: (310) 547-2882 | Mahmoud Ajang M.d., A Professional Medical Corporation 378 W 6th St San Pedro CA 90731-3338 Ph: (310) 547-1801 |
| NPI Number | 1346400819 |
|---|---|
| Provider Enumeration Date | 06/10/2008 |
| Last Update Date | 06/10/2008 |
| Medicare PECOS PAC ID | 0446319263 |
|---|---|
| Medicare Enrollment ID | O20081110000197 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346400819 | NPI | - | NPPES |
| 00A377170 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | A37717 (California) | Primary |
| Provider Name | Mahmoud Ajang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922182682 PECOS PAC ID: 6901965722 Enrollment ID: I20081110000185 |
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