Provider Demographics
NPI:1982865606
Name:GHOLAMI, SEPIDEH (MD)
Entity Type:Individual
Prefix:
First Name:SEPIDEH
Middle Name:
Last Name:GHOLAMI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UC DAVIS CANCER CENTER
Mailing Address - Street 2:4501 X STREET SUITE 3010
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2229
Mailing Address - Country:US
Mailing Address - Phone:916-734-2843
Mailing Address - Fax:916-703-5267
Practice Address - Street 1:UC DAVIS CANCER CENTER
Practice Address - Street 2:4501 X STREET SUITE 3010
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2229
Practice Address - Country:US
Practice Address - Phone:916-734-2843
Practice Address - Fax:916-703-5267
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-25
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA109810204F00000X, 208600000X, 2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery