MTH Clinic PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MTH CLINIC PC

Practice address

24988 SE Stark St
Ste 300
Gresham, OR 97030-8322

Phone

(503) 674-5818

Fax

(503) 674-6709

NPI assigned

Aug 25, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Fayyaz Mahmood, MDNPI 1790777050

Title

Ceo

Phone

(503) 674-5818

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Fayyaz Mahmood, MD

  • Internal Medicine Physician
  • Gresham, OR
  • NPI 1790777050
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1558354522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24988 SE STARK ST",
            "address_2": "STE 300",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970308322",
            "telephone_number": "503-674-5818",
            "fax_number": "503-674-6709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24988 SE STARK ST",
            "address_2": "STE 300",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970308322",
            "telephone_number": "503-674-5818",
            "fax_number": "503-674-6709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MTH CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-25",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MAHMOOD",
        "authorized_official_first_name": "FAYYAZ",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "503-674-5818",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mt Hood Women'S Health PC
• Mt. Hood Adult Day Center LLC
• Mt. Hood Vision Center, LLC
• Mt. Hood Vision, Inc
• Mt. View Rehabilitation Services, Inc.
• MTN. View Family Practice, PC
• Joanna E Mullett, MSPT
• Mulnomah County
• Mulnomah County
• Multnomah County

• Internal Medicine Physician in Gresham, OR
• Providers in Gresham, OR by specialty
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.