MEDICARE: MAHIN GHAHRAMANI

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	224Z00000X	Occupational Therapy Assistant	4949	CA

General Provider Information

NPI Number	:	1053952721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAHIN GHAHRAMANI

Provider Business Mailing Address
First Line	:	9712 CLUB PARK DR
Second Line	:
City	:	ELK GROVE
State	:	CA
Zip	:	95757-8119
Country	:	US
Telephone Number	:	916-714-0811
Fax Number	:

Provider Business Practice Location Address
First Line	:	9712 CLUB PARK DR
Second Line	:
City	:	ELK GROVE
State	:	CA
Zip	:	95757-8119
Country	:	US
Telephone Number	:	916-714-0811
Fax Number	:

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

Provider Enumeration Date	:	10/03/2019
Last Update Date	:	03/23/2023

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Directions to “ MAHIN GHAHRAMANI ” Practice Location

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