MEDICARE: AL MISBAAH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1336097914
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AL MISBAAH

Provider Business Mailing Address
First Line	:	10277 IRON ROCK WAY STE 200
Second Line	:
City	:	ELK GROVE
State	:	CA
Zip	:	95624-1360
Country	:	US
Telephone Number	:	916-501-4828
Fax Number	:

Provider Business Practice Location Address
First Line	:	10277 IRON ROCK WAY STE 200
Second Line	:
City	:	ELK GROVE
State	:	CA
Zip	:	95624-1360
Country	:	US
Telephone Number	:	916-501-4828
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MOHAMMAD Y KHAN
Credential	:
Telephone Number	:	916-501-4828

Provider Enumeration Date	:	03/19/2026
Last Update Date	:	03/19/2026

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