Provider Demographics
NPI:1740208362
Name:RAHBAR MEDICAL GROUP, INC., A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:RAHBAR MEDICAL GROUP, INC., A MEDICAL CORPORATION
Other - Org Name:RAHBAR MEDICAL GROUP, A MEDICAL CORPORATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FARSHID
Authorized Official - Middle Name:SAM
Authorized Official - Last Name:RAHBAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACP
Authorized Official - Phone:310-553-4400
Mailing Address - Street 1:2080 CENTURY PARK E
Mailing Address - Street 2:SUITE 1804
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90067-2001
Mailing Address - Country:US
Mailing Address - Phone:310-553-4400
Mailing Address - Fax:310-553-5590
Practice Address - Street 1:2080 CENTURY PARK E
Practice Address - Street 2:SUITE 1804
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90067-2001
Practice Address - Country:US
Practice Address - Phone:310-553-4400
Practice Address - Fax:310-553-5590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38265207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty