MEDICARE: SOHEIL MOTAMED MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	A698780	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ZZZ5427Z	OTHER	CA	BLUE SHIELD

General Provider Information

NPI Number	:	1053323931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOHEIL MOTAMED MD

Provider Business Mailing Address
First Line	:	39350 CIVIC CENTER DRIVE
Second Line	:	STE. 300
City	:	FREMONT
State	:	CA
Zip	:	94538-2331
Country	:	US
Telephone Number	:	510-797-3933
Fax Number	:	510-797-5184

Provider Business Practice Location Address
First Line	:	39350 CIVIC CENTER DRIVE
Second Line	:	STE. 300
City	:	FREMONT
State	:	CA
Zip	:	94538-2331
Country	:	US
Telephone Number	:	510-797-3933
Fax Number	:	510-797-5187

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2006
Last Update Date	:	05/15/2015

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Directions to “ SOHEIL MOTAMED MD” Practice Location

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