MEDICARE: DR. AYMAN MOHAMED GHOBASHY DDS

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	1223G0001X	General Practice Dentistry	49530	CA

General Provider Information

NPI Number	:	1902965759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AYMAN MOHAMED GHOBASHY DDS

Provider Business Mailing Address
First Line	:	11 JORDAN CT
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95826-1616
Country	:	US
Telephone Number	:	916-802-2079
Fax Number	:	916-388-0418

Provider Business Practice Location Address
First Line	:	5261 ELKHORN BLVD
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95842-2506
Country	:	US
Telephone Number	:	916-344-2362
Fax Number	:

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

Provider Enumeration Date	:	12/07/2006
Last Update Date	:	07/08/2007

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