Healthcare Provider Details

I. General information

NPI: 1417233735
Provider Name (Legal Business Name): ROBERT TABRIZI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ROBERT TABRIZI MD

II. Dates (important events)

Enumeration Date: 11/01/2011
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 MERCY AVE STE 400
MERCED CA
95340-8368
US

IV. Provider business mailing address

3400 DATA DR
RANCHO CORDOVA CA
95670-7956
US

V. Phone/Fax

Practice location:
  • Phone: 209-564-3700
  • Fax: 209-564-3799
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA166566
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: