1396068573 NPI number — MRS. MARGARET SANDRA HSU TAGHAVI M.D.

Table of content: MRS. MARGARET SANDRA HSU TAGHAVI M.D. (NPI 1396068573)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396068573 NPI number — MRS. MARGARET SANDRA HSU TAGHAVI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TAGHAVI
Provider First Name:
MARGARET
Provider Middle Name:
SANDRA HSU
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HSU
Provider Other First Name:
MARGARET
Provider Other Middle Name:
SANDRA
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1396068573
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/20/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3400 DATA DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RANCHO CORDOVA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95670-7956
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1380 LEAD HILL BLVD STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROSEVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95661-2941
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-535-2030
Provider Business Practice Location Address Fax Number:
916-536-3061
Provider Enumeration Date:
03/02/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  A115423 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 12758499 . This is a "CAQH" identifier . This identifiers is of the category "OTHER".