Provider Demographics
NPI:1356327597
Name:RAOUFI, RAHIM A (MD)
Entity Type:Individual
Prefix:
First Name:RAHIM
Middle Name:A
Last Name:RAOUFI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:228 S D ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436-7308
Mailing Address - Country:US
Mailing Address - Phone:805-740-6633
Mailing Address - Fax:805-740-6630
Practice Address - Street 1:228 S D ST
Practice Address - Street 2:SUITE B
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-7308
Practice Address - Country:US
Practice Address - Phone:805-740-6633
Practice Address - Fax:805-740-6630
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-20
Last Update Date:2015-03-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA94293207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA01192Medicare PIN