Provider Demographics
NPI:1598968000
Name:RAHNEMA, MOLOUK FARIBA (MD)
Entity Type:Individual
Prefix:
First Name:MOLOUK
Middle Name:FARIBA
Last Name:RAHNEMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:653 N TOWN CENTER DR
Mailing Address - Street 2:SUITE 504
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89144-0514
Mailing Address - Country:US
Mailing Address - Phone:702-701-8400
Mailing Address - Fax:702-701-8401
Practice Address - Street 1:653 N TOWN CENTER DR
Practice Address - Street 2:SUITE 504
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89144-0514
Practice Address - Country:US
Practice Address - Phone:702-701-8400
Practice Address - Fax:702-701-8401
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA88710174400000X
TXN1424207RE0101X
NV13479207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV13479OtherSTATE LICENSE