Active NPI
Abdelgabar Mohamed Mohamdian
- General Practice Physician
- Glendale, AZ
National Provider Identifier
1174855480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 476336
- Practice address
- 8528 N 43Rd Dr
Glendale, AZ 85302-5302 - Phone
- (623) 217-1559
- NPI assigned
- Feb 11, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 476336 | AZ | Primary |
Addresses
Primary practice location
8528 N 43Rd Dr
Glendale, AZ 85302-5302
Mailing address
8528 N 43Rd Dr
Glendale, AZ 85302-5302
Phone (623) 217-1559
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 476336 | AZ | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Safety One Medical Transportation | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinic/Center
- Glendale, AZ
- NPI 1023332152
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1265846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265846400000",
"number": "1174855480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8528 N 43RD DR",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853025302",
"telephone_number": "623-217-1559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8528 N 43RD DR",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853025302",
"telephone_number": "623-217-1559"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOHAMDIAN",
"first_name": "ABDELGABAR",
"middle_name": "MOHAMED",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-02-11",
"last_updated": "2010-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "AZ",
"license": "476336",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.