Provider Demographics
NPI:1518235340
Name:RASHIDI MEDICAL CORPORATION
Entity Type:Organization
Organization Name:RASHIDI MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHMOUD
Authorized Official - Middle Name:
Authorized Official - Last Name:RASHIDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-545-7175
Mailing Address - Street 1:95 MONTGOMERY DR
Mailing Address - Street 2:SUITE 118
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-6617
Mailing Address - Country:US
Mailing Address - Phone:707-545-7175
Mailing Address - Fax:707-545-7938
Practice Address - Street 1:95 MONTGOMERY DR
Practice Address - Street 2:SUITE 118
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-6617
Practice Address - Country:US
Practice Address - Phone:707-545-7175
Practice Address - Fax:707-545-7938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-07
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA87654174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty