Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | G69075 | CA |
NPI | 1033297742 |
---|---|
Provider Name | Kamran Sahrakar |
First Address | Rancho Cordova, CA 95670-7956 |
Second Address | Carmichael, CA 95608-0312 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 19/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G690750 | (05) | CA |
G28862 | (02) |