Provider Demographics
NPI:1124002480
Name:RAHBAR DENTISTRY PC
Entity Type:Organization
Organization Name:RAHBAR DENTISTRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GELAREH
Authorized Official - Middle Name:
Authorized Official - Last Name:RAHBAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:415-986-7100
Mailing Address - Street 1:133 KEARNY ST
Mailing Address - Street 2:STE 204
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-4805
Mailing Address - Country:US
Mailing Address - Phone:415-986-7100
Mailing Address - Fax:415-276-6370
Practice Address - Street 1:133 KEARNY ST
Practice Address - Street 2:STE 204
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-4805
Practice Address - Country:US
Practice Address - Phone:415-986-7100
Practice Address - Fax:415-276-6370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-01
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA427651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty