Provider Demographics
NPI:1831144732
Name:AGHAMOHAMMADI, NEEMA MOHAMMAD (DO)
Entity type:Individual
Prefix:DR
First Name:NEEMA
Middle Name:MOHAMMAD
Last Name:AGHAMOHAMMADI
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:77 CADILLAC DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-5453
Mailing Address - Country:US
Mailing Address - Phone:916-325-1040
Mailing Address - Fax:916-669-4144
Practice Address - Street 1:3637 MISSION AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-2946
Practice Address - Country:US
Practice Address - Phone:916-679-3524
Practice Address - Fax:916-679-3563
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2008-05-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA207A 7859207RP1001X
CA20A7859207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A 7859OtherOSTEOPATHIC MEDICAL BOARD
CA00AX78590Medicaid
CA20A 7859OtherOSTEOPATHIC MEDICAL BOARD
CAI69868Medicare UPIN