Provider Demographics
NPI:1326520248
Name:RAFIA, MEHRBOD (DC)
Entity Type:Individual
Prefix:DR
First Name:MEHRBOD
Middle Name:
Last Name:RAFIA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 DESCANSO DR UNIT 1136
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95134-1845
Mailing Address - Country:US
Mailing Address - Phone:301-525-5157
Mailing Address - Fax:
Practice Address - Street 1:1309 S MARY AVE STE 206
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-3060
Practice Address - Country:US
Practice Address - Phone:415-509-6632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-06
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34305111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor