Healthcare Provider Details

I. General information

NPI: 1568170546
Provider Name (Legal Business Name): ALEX MOHSENI DAYAMED PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2022
Last Update Date: 03/25/2024
Certification Date: 03/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1610 R ST STE 300-3006
SACRAMENTO CA
95811-6676
US

IV. Provider business mailing address

1000 N WEST ST
WILMINGTON DE
19801-1050
US

V. Phone/Fax

Practice location:
  • Phone: 800-931-5883
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ALEX S MOHSENI
Title or Position: PHYSICIAN OWNER
Credential: MD
Phone: 301-706-4461