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NPI Code Detail

MEDICARE: MR. TAIMER TAASH SORKHABI

MEDICARE: MR. TAIMER TAASH SORKHABI
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
1172V00000XCommunity Health WorkerCA
2106S00000XBehavior Technician
3373H00000XDay Training/Habilitation Specialist
4225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1548901440
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TAIMER TAASH SORKHABI
Provider Business Mailing Address
First Line : 8945 GOLF LINKS RD
Second Line :
City : OAKLAND
State : CA
Zip : 94605-4124
Country : US
Telephone Number : 510-317-1444
Fax Number :
Provider Business Practice Location Address
First Line : 1025 ATLANTIC AVE STE 101
Second Line :
City : ALAMEDA
State : CA
Zip : 94501-1188
Country : US
Telephone Number : 510-268-8120
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2022
Last Update Date : 03/20/2026

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