Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | A381910 | CA |
NPI | 1003980731 |
---|---|
Provider Name | Dr. A. Reza Ehyai |
First Address | Sacramento, CA 95825-6372 |
Second Address | Sacramento, CA 95825-6372 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A28560 | (02) | CA |