Provider Demographics
NPI:1194774075
Name:FATTEH, PARVEZ MEHBOOB (MD)
Entity type:Individual
Prefix:DR
First Name:PARVEZ
Middle Name:MEHBOOB
Last Name:FATTEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1037 DEER CREEK CT
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-3446
Mailing Address - Country:US
Mailing Address - Phone:510-427-4268
Mailing Address - Fax:510-319-8775
Practice Address - Street 1:2033 GATEWAY PL
Practice Address - Street 2:5TH FL OFFICE 647
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95110-3709
Practice Address - Country:US
Practice Address - Phone:408-539-5652
Practice Address - Fax:559-546-4823
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-09
Last Update Date:2025-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA66560208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH38587Medicare UPIN