Provider Demographics
NPI:1922026897
Name:ROOHIPOUR, HALEH (MD)
Entity Type:Individual
Prefix:DR
First Name:HALEH
Middle Name:
Last Name:ROOHIPOUR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:462 N LINDEN DR STE 249
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-2203
Mailing Address - Country:US
Mailing Address - Phone:310-859-9500
Mailing Address - Fax:310-859-9300
Practice Address - Street 1:462 N LINDEN DR STE 249
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212
Practice Address - Country:US
Practice Address - Phone:310-859-9500
Practice Address - Fax:310-859-9300
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA84198207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI23275Medicare UPIN