| Ebrahim Ahmadi, M D Inc. | |
|
38143 Martha Ave Fremont CA 94536-3800 | |
| (510) 791-2002 | |
| Not Available |
| Full Name | Ebrahim Ahmadi, M D Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 38143 Martha Ave, Fremont, California |
| Authorized Official Name and Position | Ebrahim Ahmadi (CEO) |
| Authorized Official Contact | 5107912002 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ebrahim Ahmadi, M D Inc. 38143 Martha Ave Fremont CA 94536-3800 Ph: (510) 791-2002 | Ebrahim Ahmadi, M D Inc. 38143 Martha Ave Fremont CA 94536-3800 Ph: (510) 791-2002 |
| NPI Number | 1710134465 |
|---|---|
| Provider Enumeration Date | 08/25/2008 |
| Last Update Date | 11/11/2022 |
| Medicare PECOS PAC ID | 6305914557 |
|---|---|
| Medicare Enrollment ID | O20081001000532 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710134465 | NPI | - | NPPES |
| 00A503131 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | AO50313 (California) | Primary |
| Provider Name | Ebrahim Ahmadi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417008426 PECOS PAC ID: 9133297385 Enrollment ID: I20081001000527 |
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