Provider Demographics
NPI:1275581357
Name:MAHER, ROOHBAKHSH (DPM)
Entity Type:Individual
Prefix:
First Name:ROOHBAKHSH
Middle Name:
Last Name:MAHER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2850 ARTESIA BLVD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-3419
Mailing Address - Country:US
Mailing Address - Phone:310-214-9700
Mailing Address - Fax:310-214-9790
Practice Address - Street 1:2850 ARTESIA BLVD.
Practice Address - Street 2:SUITE 204
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90278-3417
Practice Address - Country:US
Practice Address - Phone:310-214-9700
Practice Address - Fax:310-214-9790
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAE40240213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E40240OtherMEDICAL
CA200717977OtherHEALTHNET
CA200717977OtherBLUE CROSS OF CALIFORNIA
CA200717977OtherAARP
CA200717977OtherMOTION PICTURE INDUSTRY
CA200717977OtherEMPLOYEE HEALTH SYSTEMS
CA200717977OtherPACIFICARE
CA200717977OtherAETNA
CA200717977OtherUNITED HEALTHCARE
CA200717977OtherBLUE SHIELD OF CALIFORNIA
CA200717977OtherMEDPOINT MANAGEMENT
CA200717977OtherTRICARE
CA200717977OtherUHP HEALTHCARE
CA200717977OtherCIGNA
CA200717977OtherLA VIDA MEDICAL GROUP IPA
CA200717977OtherAETNA
CA200717977OtherHEALTHNET
CA200717977OtherBLUE CROSS OF CALIFORNIA