Healthcare Provider Details

I. General information

NPI: 1982520722
Provider Name (Legal Business Name): AWAN M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 21ST ST # 14317
SACRAMENTO CA
95811-5226
US

IV. Provider business mailing address

1401 21ST ST # 14317
SACRAMENTO CA
95811-5226
US

V. Phone/Fax

Practice location:
  • Phone: 916-500-4986
  • Fax:
Mailing address:
  • Phone: 916-500-4986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ASADULLAH AWAN
Title or Position: CHIEF MEDICAL OFFICER
Credential: MD
Phone: 916-500-4986