MEDICARE: REEM FALAH AL MAGSOOSI

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	122300000X	Dentist	107183	CA

General Provider Information

NPI Number	:	1619636917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REEM FALAH AL MAGSOOSI

Provider Business Mailing Address
First Line	:	5300 HACKBERRY LN APT 110
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95841-3255
Country	:	US
Telephone Number	:	571-315-7198
Fax Number	:

Provider Business Practice Location Address
First Line	:	5300 HACKBERRY LN APT 110
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95841-3255
Country	:	US
Telephone Number	:	571-315-7198
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2021
Last Update Date	:	12/14/2021

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Directions to “ REEM FALAH AL MAGSOOSI ” Practice Location

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