Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | A121709 | CA |
NPI | 1083877377 |
---|---|
Provider Name | Sorour Rahgoshay |
First Address | Rancho Cordova, CA 95670-7956 |
Second Address | Sacramento, CA 95816-7058 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2008 |
Last Update Date | 03/12/2021 |