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NPI Code Detail

MEDICARE: ENTHEO CLINIC, A PROFESSIONAL MEDICAL CORPORATION

MEDICARE: ENTHEO CLINIC, A PROFESSIONAL MEDICAL CORPORATION
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
12084P0800XPsychiatry Physician

General Provider Information

NPI Number : 1871422790
Entity Type Code : Organization
Provider Name (Legal Business Name) : ENTHEO CLINIC, A PROFESSIONAL MEDICAL CORPORATION
Provider Business Mailing Address
First Line : 1700 EUREKA RD STE 155
Second Line :
City : ROSEVILLE
State : CA
Zip : 95661-7786
Country : US
Telephone Number : 916-304-2214
Fax Number : 916-938-2250
Provider Business Practice Location Address
First Line : 1700 EUREKA RD STE 155
Second Line :
City : ROSEVILLE
State : CA
Zip : 95661-7786
Country : US
Telephone Number : 916-304-2214
Fax Number : 916-938-2250
Authorized Official
Title or Position : FOUNDER
Name : RIAN KABIR
Credential : MD
Telephone Number : 916-304-2214
Provider Enumeration Date : 05/16/2026
Last Update Date : 05/18/2026

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Directions to “ENTHEO CLINIC, A PROFESSIONAL MEDICAL CORPORATION ” Practice Location

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