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General NPI Number Information
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NPI Number | 1689782245
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Entity Type | Individual
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Provider Name | JAHANGIR SADEGHI M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 950 NORTHGATE DR
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City | SAN RAFAEL
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State | CA
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Zip | 94903-3433
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Country | US
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Telephone | 415-479-2372
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Fax | 415-472-6225
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Provider Business Mailing Address
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Address Line | 950 NORTHGATE DR SUITE 209
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City | SAN RAFAEL
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State | CA
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Zip | 94903-3414
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Country | US
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Telephone | 415-479-2372
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Fax | 415-472-6225
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 483-265146
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | C50518
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License Number State | CA
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