Basic Information
| Provider Information | |||||||||
| NPI: | 1366679615 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MOHAMMED | ||||||||
| FirstName: | JAMAL MUJADDID | ||||||||
| MiddleName: | MASEEL | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4150 V ST # 3400 | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958171460 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9167343575 | ||||||||
| FaxNumber: | 9167347924 | ||||||||
| Practice Location | |||||||||
| Address1: | 4150 V ST # 3400 | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958171460 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9167343575 | ||||||||
| FaxNumber: | 9167347924 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2009 | ||||||||
| LastUpdateDate: | 07/24/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | BP10035328 | TX | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | P3392 | TX | N | Allopathic & Osteopathic Physicians | Family Medicine | 207QS1201X | A126021 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine | Sleep Medicine |
No ID Information.