Basic Information
| Provider Information | |||||||||
| NPI: | 1194779751 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SOHRABI | ||||||||
| FirstName: | HOMAYOUN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5849 W BUENA VISTA AVE | ||||||||
| Address2: | |||||||||
| City: | VISALIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932919172 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5597392902 | ||||||||
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| Practice Location | |||||||||
| Address1: | 372 W CYPRESS AVE | ||||||||
| Address2: | |||||||||
| City: | REEDLEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 936542113 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5596388155 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2006 | ||||||||
| LastUpdateDate: | 09/28/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | G82012 | CA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207R00000X | G82012 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207P00000X | G82012 | CA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 00G820120 | 05 | CA | MEDICAID |