Healthcare Provider Details

I. General information

NPI: 1376095653
Provider Name (Legal Business Name): SAIF FARHAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: SAIF ALDEEN BASSAM FARHAN M.D.

II. Dates (important events)

Enumeration Date: 11/02/2016
Last Update Date: 07/17/2020
Certification Date: 07/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4860 Y ST STE 1700
SACRAMENTO CA
95817-2307
US

IV. Provider business mailing address

4860 Y ST STE 3800
SACRAMENTO CA
95817-2307
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-2700
  • Fax: 913-703-5074
Mailing address:
  • Phone: 916-734-2807
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberA162951
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA162951
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: