Individual
MIRZA ALI ALIKHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1020 29TH STREET, SUITE 570B, SACRAMENTO, CA 95816-5125
(916) 733-3792
(916) 733-8250
Mailing address
10470 OLD PLACERVILLER ROAD, SUITE 100, SACRAMENTO, CA 95827-2539
(800) 470-0071
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
104996
MN
207N00000X
Dermatology Physician
35.121766
OH
207N00000X
Dermatology Physician
53257
MN
207N00000X
Dermatology Physician
Primary
A149786
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
MN
01
—
P00909063
RAILROAD MEDICARE
MN
Enumeration date
07/30/2007
Last updated
07/21/2022
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