MEDICARE: DR. JAHANGIR SADEGHI 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	207W00000X	Ophthalmology Physician	483-265146	CA
2	207W00000X	Ophthalmology Physician	C50518	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	483265146	OTHER	CA	STATE ID
2	C50518	OTHER	CA	MEDICAL LICENSE NUMBER

General Provider Information

NPI Number	:	1689782245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAHANGIR SADEGHI M.D.

Provider Business Mailing Address
First Line	:	950 NORTHGATE DR
Second Line	:	SUITE 209
City	:	SAN RAFAEL
State	:	CA
Zip	:	94903-3414
Country	:	US
Telephone Number	:	415-479-2372
Fax Number	:	415-472-6225

Provider Business Practice Location Address
First Line	:	950 NORTHGATE DR
Second Line	:
City	:	SAN RAFAEL
State	:	CA
Zip	:	94903-3433
Country	:	US
Telephone Number	:	415-479-2372
Fax Number	:	415-472-6225

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

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	03/07/2023

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Directions to “ DR. JAHANGIR SADEGHI M.D.” Practice Location

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