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Contact Information

MOHAMMAD S KANAKRIYEH, MD
350 E VANDERBILT WAY
STE A
SAN BERNARDINO, CA92408
 Phone: 909-886-5200
 Fax: 909-382-9017
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Cardiology

2080P0202X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for MOHAMMAD S KANAKRIYEH · (Male)

NPI # 1164512281
Status Active
Credentials MD
Entity Individual
Enumeration date 10/13/2006
Last updated 02/12/2019 - About 7 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # A42526
  • CA Medicaid 00A425260
  • CA Other 330698865 BLUE CROSS
  • CA Other ZZZ51351Z BLUE SHIELD
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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