Healthcare Provider Details

I. General information

NPI: 1831144732
Provider Name (Legal Business Name): NEEMA MOHAMMAD AGHAMOHAMMADI D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 05/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3637 MISSION AVE SUITE 7
CARMICHAEL CA
95608-2946
US

IV. Provider business mailing address

77 CADILLAC DR SUITE 210
SACRAMENTO CA
95825-5453
US

V. Phone/Fax

Practice location:
  • Phone: 916-679-3524
  • Fax: 916-679-3563
Mailing address:
  • Phone: 916-325-1040
  • Fax: 916-669-4144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number20A7859
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number207A 7859
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: