Provider Demographics
NPI:1083827984
Name:RAHIMIAN, MAHTAB (DC)
Entity Type:Individual
Prefix:DR
First Name:MAHTAB
Middle Name:
Last Name:RAHIMIAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5423 BONFAIR AVENUE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712
Mailing Address - Country:US
Mailing Address - Phone:562-630-6720
Mailing Address - Fax:562-942-9432
Practice Address - Street 1:9519 TELEGRAPH ROAD
Practice Address - Street 2:SUITE F
Practice Address - City:PICO RIVERA
Practice Address - State:CA
Practice Address - Zip Code:90660
Practice Address - Country:US
Practice Address - Phone:562-942-9432
Practice Address - Fax:909-622-5543
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25371111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor