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MR. MARK-MUSHTAQ JAVED AHMED NP

>> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1780652818

Individual Registrant:
MR. MARK-MUSHTAQ JAVED AHMED NP
Gender: M
Not Sole Proprietor

Location and contact information for practice:
5342 DUDLEY BLVD  MCCLELLAN, CA 95652-1012 US
Tel: 916-561-7473  Fax: 916-561-7440

Contact information for business:
23 GOOSE HAVEN CT  SACRAMENTO, CA 95834-2506 US
Tel: 916-575-9392  Fax: --

Registration Information:
NPI: 1780652818
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363L00000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
CA466078

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS CA - Page 1



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