Provider Demographics
NPI:1821495482
Name:KOUROSH RAHIMPOUR DDS, PC
Entity Type:Organization
Organization Name:KOUROSH RAHIMPOUR DDS, PC
Other - Org Name:OC FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KOUROSH
Authorized Official - Middle Name:
Authorized Official - Last Name:RAHIMPOUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-466-9616
Mailing Address - Street 1:23532 EL TORO RD STE 4
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-4703
Mailing Address - Country:US
Mailing Address - Phone:949-837-6453
Mailing Address - Fax:949-837-6459
Practice Address - Street 1:23532 EL TORO RD
Practice Address - Street 2:SUITE 4
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-4703
Practice Address - Country:US
Practice Address - Phone:949-466-9616
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-26
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA559171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty