| Doctor Name: | MS. MARYAM FATHMA AHMAD |
| NPI Number: | 1043211733 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 15210 |
| Business Practice Address: | 11133 Omelveny Ave San Fernando, CA - 913404426 |
| Business Phone Number: | 8183657517 |
| Business Fax Number: | 8188377127 |
| Mailing Address: | 1172 N Maclay Ave, SAN FERNANDO |
| State: | CA |
| Postal Code: | 913401328 |
| Phone Number: | 8188981388 |
| Fax Number: | 8183654031 |
| NPI Enumeration Date: | 08/03/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 15210 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |