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General NPI Number Information
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NPI Number | 1821693193
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Entity Type | Organization
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Legal Business Name | ROXANA AMINBAKHSH MD A PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 12/03/2020
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Last Update Date | 02/20/2023
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Provider Practice Location Address
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Address Line | 825 E BIDWELL ST STE 400
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City | FOLSOM
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State | CA
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Zip | 95630-4207
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Country | US
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Telephone | 858-900-6004
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Fax |
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Provider Business Mailing Address
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Address Line | 14055 SADDLEBOW DR
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City | RENO
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State | NV
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Zip | 89511-6747
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Country | US
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Telephone | 858-900-6004
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. ROXANA AMINBAKHSH
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Credential | MD
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Telephone | 858-900-6004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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