Provider Demographics
NPI:1326440124
Name:RAHNAVARD, AMIR ALI (MD)
Entity Type:Individual
Prefix:
First Name:AMIR
Middle Name:ALI
Last Name:RAHNAVARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23845 HOLMAN HWY STE 203
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-5901
Mailing Address - Country:US
Mailing Address - Phone:831-241-9155
Mailing Address - Fax:831-886-3616
Practice Address - Street 1:23845 HOLMAN HWY STE 203
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5901
Practice Address - Country:US
Practice Address - Phone:831-241-9155
Practice Address - Fax:831-886-3616
Is Sole Proprietor?:No
Enumeration Date:2014-09-23
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA153979208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation