Healthcare Provider Details

I. General information

NPI: 1811692957
Provider Name (Legal Business Name): MUSHGAN NASSIRI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2023
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7551 MADISON AVE
CITRUS HEIGHTS CA
95610-7449
US

IV. Provider business mailing address

7551 MADISON AVE
CITRUS HEIGHTS CA
95610-7449
US

V. Phone/Fax

Practice location:
  • Phone: 916-946-9733
  • Fax:
Mailing address:
  • Phone: 916-904-3000
  • Fax: 916-703-7979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA205512
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: