Healthcare Provider Details

I. General information

NPI: 1255109948
Provider Name (Legal Business Name): NIAZI FAMILY MEDICINE & URGENT CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2023
Last Update Date: 06/17/2024
Certification Date: 06/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7275 E SOUTHGATE DR STE 102
SACRAMENTO CA
95823-2610
US

IV. Provider business mailing address

PO BOX 231013
SACRAMENTO CA
95823-0400
US

V. Phone/Fax

Practice location:
  • Phone: 916-244-4464
  • Fax: 310-269-1609
Mailing address:
  • Phone: 916-244-4464
  • Fax: 833-384-6858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HAYATULLAH NIAZI
Title or Position: PRESIDENT
Credential: PA
Phone: 916-244-4464