Provider Demographics
NPI:1669665972
Name:RAHIM KARJOO MD INC.
Entity Type:Organization
Organization Name:RAHIM KARJOO MD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RAHIM
Authorized Official - Middle Name:
Authorized Official - Last Name:KARJOO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-636-0261
Mailing Address - Street 1:12665 GARDEN GROVE BLVD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-1901
Mailing Address - Country:US
Mailing Address - Phone:714-636-0261
Mailing Address - Fax:714-636-0263
Practice Address - Street 1:12665 GARDEN GROVE BLVD
Practice Address - Street 2:SUITE 111
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-1915
Practice Address - Country:US
Practice Address - Phone:714-636-0261
Practice Address - Fax:714-636-0263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-20
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC37311173000000X, 291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Multi-Specialty
No291U00000XLaboratoriesClinical Medical LaboratoryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE48169Medicare UPIN
C37311Medicare PIN