Healthcare Provider Details

I. General information

NPI: 1306285739
Provider Name (Legal Business Name): MANAN A JHAVERI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2013
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8120 TIMBERLAKE WAY STE 101
SACRAMENTO CA
95823-5413
US

IV. Provider business mailing address

3160 FOLSOM BLVD
SACRAMENTO CA
95816-5202
US

V. Phone/Fax

Practice location:
  • Phone: 916-681-6159
  • Fax: 916-689-4095
Mailing address:
  • Phone: 859-489-6068
  • Fax: 859-838-9220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberA168382
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number297953
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: