Healthcare Provider Details

I. General information

NPI: 1033029608
Provider Name (Legal Business Name): VISHAN DIMRI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 N 6TH ST APT 8307
SACRAMENTO CA
95811-0395
US

IV. Provider business mailing address

501 N 6TH ST APT 8307
SACRAMENTO CA
95811-0395
US

V. Phone/Fax

Practice location:
  • Phone: 510-367-0899
  • Fax:
Mailing address:
  • Phone: 510-367-0899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number86517
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: