Healthcare Provider Details

I. General information

NPI: 1033154018
Provider Name (Legal Business Name): ARASH NASSIM YAZD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 07/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 DUCKHORN DR SUITE 100
SACRAMENTO CA
95834
US

IV. Provider business mailing address

2206 MINDEN WAY
SACRAMENTO CA
95835-1319
US

V. Phone/Fax

Practice location:
  • Phone: 916-575-8000
  • Fax:
Mailing address:
  • Phone: 916-285-0423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number22143
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number22143
License Number StateNE
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC52794
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: