Healthcare Provider Details

I. General information

NPI: 1437597739
Provider Name (Legal Business Name): SAHAB YAQUBI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2013
Last Update Date: 10/10/2023
Certification Date: 10/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 POST ST STE 500
SAN FRANCISCO CA
94108-4908
US

IV. Provider business mailing address

1270 CAMPUS DR
BERKELEY CA
94708-2045
US

V. Phone/Fax

Practice location:
  • Phone: 844-867-8444
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License Number286123
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License NumberA170576
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA170576
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: