Healthcare Provider Details

I. General information

NPI: 1942886379
Provider Name (Legal Business Name): JOSEPH NATHANIEL MEHRABI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4860 Y ST STE 100
SACRAMENTO CA
95817-2309
US

IV. Provider business mailing address

4860 Y ST STE 100
SACRAMENTO CA
95817-2309
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-2737
  • Fax:
Mailing address:
  • Phone: 916-734-2737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA194640
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: