Healthcare Provider Details

I. General information

NPI: 1639795743
Provider Name (Legal Business Name): RIAN KABIR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2020
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 EUREKA RD STE 155
ROSEVILLE CA
95661-7786
US

IV. Provider business mailing address

1700 EUREKA RD STE 155
ROSEVILLE CA
95661-7786
US

V. Phone/Fax

Practice location:
  • Phone: 916-304-2214
  • Fax:
Mailing address:
  • Phone: 916-304-2214
  • Fax: 916-938-2250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number208662
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: