Provider Demographics
NPI:1649595026
Name:PARIKH, MAMTA (MD, MS)
Entity Type:Individual
Prefix:DR
First Name:MAMTA
Middle Name:
Last Name:PARIKH
Suffix:
Gender:F
Credentials:MD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 X ST STE 3016
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2229
Mailing Address - Country:US
Mailing Address - Phone:916-734-3772
Mailing Address - Fax:916-734-7946
Practice Address - Street 1:2279 45TH STREET
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2229
Practice Address - Country:US
Practice Address - Phone:916-734-5959
Practice Address - Fax:916-703-5265
Is Sole Proprietor?:No
Enumeration Date:2010-03-29
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA123686207RH0000X, 207R00000X, 207RX0202X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA390200000XOtherSTUDENT