Healthcare Provider Details

I. General information

NPI: 1902039902
Provider Name (Legal Business Name): SANAZ ABDERRAHMANE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2009
Last Update Date: 06/26/2023
Certification Date: 06/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3939 J ST STE 320
SACRAMENTO CA
95819-3666
US

IV. Provider business mailing address

3400 DATA DR
RANCHO CORDOVA CA
95670-7956
US

V. Phone/Fax

Practice location:
  • Phone: 916-733-5995
  • Fax: 916-281-3862
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberA115623
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: