Healthcare Provider Details

I. General information

NPI: 1780628875
Provider Name (Legal Business Name): MEHDI K ARAB M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 10/03/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6555 COYLE AVE SUITE 310
CARMICHAEL CA
95608-0302
US

IV. Provider business mailing address

5051 JARDIN LANE
CARMICHAEL CA
95608
US

V. Phone/Fax

Practice location:
  • Phone: 916-965-4612
  • Fax: 916-965-9384
Mailing address:
  • Phone: 916-996-4568
  • Fax: 916-965-9384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA42130
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: