Individual
DR. JOHN MOGANNAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4900 BROADWAY STE 2700, SACRAMENTO, CA 95820-1536
(916) 734-9913
Mailing address
378 EMBARCADERO W UNIT 419, OAKLAND, CA 94607-4534
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
20A22102
CA
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
20A22102
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/19/2022
Last updated
03/12/2026
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