Provider Demographics
NPI:1366413270
Name:AHMAD, SOHAIL S (MD)
Entity type:Individual
Prefix:
First Name:SOHAIL
Middle Name:S
Last Name:AHMAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:36915 COOK ST
Mailing Address - Street 2:STE 103
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92211-6067
Mailing Address - Country:US
Mailing Address - Phone:760-340-1003
Mailing Address - Fax:760-340-4844
Practice Address - Street 1:36915 COOK ST
Practice Address - Street 2:STE 103
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211-6067
Practice Address - Country:US
Practice Address - Phone:760-340-1003
Practice Address - Fax:760-340-4844
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG85632207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
347527000OtherUS DEPT LABOR
347527000OtherUS DEPT LABOR
CA00G856321Medicare ID - Type Unspecified