Provider Demographics
NPI:1548092976
Name:GERAMI, BIJAN
Entity type:Individual
Prefix:
First Name:BIJAN
Middle Name:
Last Name:GERAMI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3427 E ISLAND CT
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-7442
Mailing Address - Country:US
Mailing Address - Phone:916-955-1684
Mailing Address - Fax:
Practice Address - Street 1:3427 E ISLAND CT
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-7442
Practice Address - Country:US
Practice Address - Phone:916-955-1684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-15
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle