Active NPI
Mohammed Farouk Mahdi, PT
- Physical Therapist
- Perris, CA
National Provider Identifier
1891967709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT28513
- Practice address
- 2226 Medical Center Dr Ste 101
Perris, CA 92571-2657 - Phone
- (951) 657-6559
- Fax
- (951) 657-0661
- NPI assigned
- Mar 31, 2008
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT28513 | CA | Primary |
Addresses
Primary practice location
2226 Medical Center Dr Ste 101
Perris, CA 92571-2657
Mailing address
1717 E Lincoln Ave
Anaheim, CA 92805-4345
Phone (714) 635-2642
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT28513 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278979200000",
"number": "1891967709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1717 E LINCOLN AVE",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928054345",
"telephone_number": "714-635-2642",
"fax_number": "714-635-8547"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2226 MEDICAL CENTER DR STE 101",
"city": "PERRIS",
"state": "CA",
"postal_code": "925712657",
"telephone_number": "951-657-6559",
"fax_number": "951-657-0661"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHDI",
"first_name": "MOHAMMED",
"middle_name": "FAROUK",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-03-31",
"last_updated": "2010-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT28513",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Perris, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.