Individual
KAYVAN D HADDADAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
650 HOWE AVE STE 600, SACRAMENTO, CA 95825-4797
(916) 953-7571
(916) 771-8515
Mailing address
729 SUNRISE AVE STE 611, ROSEVILLE, CA 95661-4548
(916) 953-7571
(916) 771-8515
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
A87957
CA
208VP0000X
Pain Medicine Physician
Primary
A87957
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00745259
MEDICARE RAILROAD CARRIER
CA
Enumeration date
05/03/2006
Last updated
04/08/2019
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