Healthcare Provider Details

I. General information

NPI: 1184827719
Provider Name (Legal Business Name): ROBERT NEZAMI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2007
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39899 BALENTINE DR STE 200
NEWARK CA
94560-5361
US

IV. Provider business mailing address

1550 THE ALAMEDA STE 105
SAN JOSE CA
95126-2323
US

V. Phone/Fax

Practice location:
  • Phone: 510-744-3688
  • Fax: 510-744-3689
Mailing address:
  • Phone: 408-295-8111
  • Fax: 408-295-8110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA92147
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: