Provider Demographics
NPI:1558577163
Name:PONEH RAHIMI, MD, INC
Entity Type:Organization
Organization Name:PONEH RAHIMI, MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PONEH
Authorized Official - Middle Name:
Authorized Official - Last Name:RAHIMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-364-2536
Mailing Address - Street 1:PO BOX 2636
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92690-0636
Mailing Address - Country:US
Mailing Address - Phone:949-364-2536
Mailing Address - Fax:949-388-8013
Practice Address - Street 1:26812 BARKSTONE LN
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-7567
Practice Address - Country:US
Practice Address - Phone:310-893-9026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA76910207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty