MEDICARE: DR. CYRUS EMIL TAGHAVI M.D.

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	A119827	CA
2	207XX0004X	Orthopaedic Foot and Ankle Surgery Physician	A119827	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A119827	OTHER	CA	MEDICAL LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316268519
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CYRUS EMIL TAGHAVI M.D.

Provider Business Mailing Address
First Line	:	10470 OLD PLACERVILLE RD STE 100
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95827-2539
Country	:	US
Telephone Number	:	800-470-0071
Fax Number	:

Provider Business Practice Location Address
First Line	:	2020 SUTTER PL STE 104
Second Line	:
City	:	DAVIS
State	:	CA
Zip	:	95616-6217
Country	:	US
Telephone Number	:	530-750-5900
Fax Number	:	530-750-5901

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

Provider Enumeration Date	:	06/22/2010
Last Update Date	:	03/05/2020

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