Healthcare Provider Details

I. General information

NPI: 1669283768
Provider Name (Legal Business Name): SEHAT MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2025
Last Update Date: 01/17/2025
Certification Date: 01/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2904 LAS GALLINAS AVE
SAN RAFAEL CA
94903-1417
US

IV. Provider business mailing address

2904 LAS GALLINAS AVE
SAN RAFAEL CA
94903-1417
US

V. Phone/Fax

Practice location:
  • Phone: 415-847-9700
  • Fax:
Mailing address:
  • Phone: 415-847-9700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MEENAL LOHTIA
Title or Position: CEO
Credential: MD
Phone: 415-847-9700