Provider Demographics
NPI:1962478487
Name:MORGAN, PARHAM V (MD)
Entity Type:Individual
Prefix:
First Name:PARHAM
Middle Name:V
Last Name:MORGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1800 HARRISON ST FL 7
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-3466
Mailing Address - Country:US
Mailing Address - Phone:916-614-4015
Mailing Address - Fax:510-625-6226
Practice Address - Street 1:1650 RESPONSE RD
Practice Address - Street 2:THE PERMANENTE MEDICAL GROUP
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95815-4807
Practice Address - Country:US
Practice Address - Phone:916-614-4015
Practice Address - Fax:510-625-6226
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI47880207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34626800Medicaid
041G15875Medicare ID - Type Unspecified
I27332Medicare UPIN