1194774075 NPI number — DR. PARVEZ MEHBOOB FATTEH M.D.

Table of content: DR. PARVEZ MEHBOOB FATTEH M.D. (NPI 1194774075)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194774075 NPI number — DR. PARVEZ MEHBOOB FATTEH M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FATTEH
Provider First Name:
PARVEZ
Provider Middle Name:
MEHBOOB
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194774075
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/05/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1037 DEER CREEK CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PLEASANTON
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94566-3446
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
510-427-4268
Provider Business Mailing Address Fax Number:
510-319-8775

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2033 GATEWAY PL
Provider Second Line Business Practice Location Address:
5TH FL OFFICE 647
Provider Business Practice Location Address City Name:
SAN JOSE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95110-3709
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-539-5652
Provider Business Practice Location Address Fax Number:
559-546-4823
Provider Enumeration Date:
05/09/2006

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: 208100000X , with the licence number:  A66560 , 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)





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