Provider Demographics
NPI:1942233853
Name:RAHBAR, GUITA (MD)
Entity Type:Individual
Prefix:
First Name:GUITA
Middle Name:
Last Name:RAHBAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14445 OLIVE VIEW DR.
Mailing Address - Street 2:RM # 6B-119H
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342-0001
Mailing Address - Country:US
Mailing Address - Phone:818-364-4096
Mailing Address - Fax:
Practice Address - Street 1:14445 OLIVE VIEW DR.
Practice Address - Street 2:RM # 6B-119H
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-0001
Practice Address - Country:US
Practice Address - Phone:818-364-4096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG790182085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G790180OtherMEDICAL
CA00G790180OtherMEDICAL
CAG69039Medicare UPIN