Basic Information
| Provider Information | |||||||||
| NPI: | 1629429980 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MOHSIN | ||||||||
| FirstName: | ADNAN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9655 MONTE VISTA AVE | ||||||||
| Address2: | STE 402 | ||||||||
| City: | MONTCLAIR | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917632238 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9096261205 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9635 MONTE VISTA AVE STE 205 | ||||||||
| Address2: | |||||||||
| City: | MONTCLAIR | ||||||||
| State: | CA | ||||||||
| PostalCode: | 91763 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9096210009 | ||||||||
| FaxNumber: | 9093999265 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2016 | ||||||||
| LastUpdateDate: | 08/06/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | A159657 | CA | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | A159657 | CA | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.