MEDICARE: MEHRAD ABEDI 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	174400000X	Specialist	C53685	CA
2	207RH0003X	Hematology & Oncology Physician	MD11029	CA
3	207RH0003X	Hematology & Oncology Physician	C53685	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467459222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEHRAD ABEDI M.D.

Provider Business Mailing Address
First Line	:	4501 X ST
Second Line	:	SUITE 3016
City	:	SACRAMENTO
State	:	CA
Zip	:	95817-2229
Country	:	US
Telephone Number	:	916-734-3771
Fax Number	:	916-734-7946

Provider Business Practice Location Address
First Line	:	4501 X ST STE 3016
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95817-2229
Country	:	US
Telephone Number	:	916-734-5981
Fax Number	:	916-734-0631

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

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	08/30/2019

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Directions to “ MEHRAD ABEDI M.D.” Practice Location

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