Individual provider Active NPI

Hamid Bahramand

  • Nurse Practitioner
  • Lodi, CA
National Provider Identifier
1760276778
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95034599 Issued in CA
Practice address
975 S Fairmont Ave
Lodi, CA 95240-5118
Phone
(209) 334-3411
NPI assigned
Apr 7, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95034599 CA Primary

Addresses

Primary practice location

975 S Fairmont Ave
Lodi, CA 95240-5118

Mailing address

6007 Windbreaker Way
Sacramento, CA 95823-6912
Phone (916) 559-1419

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250430003146 CA Practitioner - Nurse Practitioner 6608392808 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Physicians Network CurrentSince Apr 28, 2025 Accepting new patients
Adventist Health Physicians Network CurrentSince Apr 28, 2025 Accepting new patients
Adventist Health Physicians Network Current Accepting new patients

Locations

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1743984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1760276778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6007 WINDBREAKER WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958236912",
            "telephone_number": "916-559-1419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 S FAIRMONT AVE",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952405118",
            "telephone_number": "209-334-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAHRAMAND",
        "first_name": "HAMID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-07",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95034599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lodi, CA

Sources for this page

Verify at the official NPI Registry.