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General NPI Number Information
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NPI Number | 1083242960
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Entity Type | Individual
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Provider Name | NOMAN GHIASI MD
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Gender | Male
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Dates
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Enumeration Date | 03/27/2020
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 568 N SUNRISE AVE STE 250
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City | ROSEVILLE
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State | CA
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Zip | 95661-3097
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Country | US
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Telephone | 916-865-1140
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Fax | 916-865-1145
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Provider Business Mailing Address
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Address Line | PO BOX 255228
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City | SACRAMENTO
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State | CA
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Zip | 95865-5228
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Country | US
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Telephone | 800-470-0071
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Fax | 916-854-6769
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 84017
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A204094
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License Number State | CA
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