Provider Demographics
NPI:1518137504
Name:M . RAHBAR, MD, INC.
Entity Type:Organization
Organization Name:M . RAHBAR, MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARYAM
Authorized Official - Middle Name:
Authorized Official - Last Name:RAHBAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-847-3666
Mailing Address - Street 1:PO BOX 13189
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92658-5088
Mailing Address - Country:US
Mailing Address - Phone:714-847-3666
Mailing Address - Fax:714-847-7171
Practice Address - Street 1:17742 BEACH BLVD
Practice Address - Street 2:SUITE 355
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-6853
Practice Address - Country:US
Practice Address - Phone:714-847-3666
Practice Address - Fax:714-847-7171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA80577207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0-463-898-7OtherECFMG
CAA80577OtherSTATE LICENSE
CAA80577OtherSTATE LICENSE
CA0-463-898-7OtherECFMG