Provider Demographics
NPI:1003898693
Name:RAHBAR, SOHRAB (DDS)
Entity Type:Individual
Prefix:DR
First Name:SOHRAB
Middle Name:
Last Name:RAHBAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 CREEK RD.
Mailing Address - Street 2:SUITE 170
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-4805
Mailing Address - Country:US
Mailing Address - Phone:949-551-9999
Mailing Address - Fax:949-551-9009
Practice Address - Street 1:33 CREEK RD
Practice Address - Street 2:SUITE 170
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4791
Practice Address - Country:US
Practice Address - Phone:949-551-9999
Practice Address - Fax:949-551-9009
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD45961122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered122300000XDental ProvidersDentist
Not Answered1223G0001XDental ProvidersDentistGeneral Practice