Provider Demographics
NPI:1982216214
Name:RAHA AKHAVANA INC. A PROFESSIONAL MEDICAL CORPORATION
Entity Type:Organization
Organization Name:RAHA AKHAVANA INC. A PROFESSIONAL MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLERK
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:KHOSROW
Authorized Official - Last Name:HAKIMIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-335-0260
Mailing Address - Street 1:9667 BRIGHTON WAY
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5125
Mailing Address - Country:US
Mailing Address - Phone:424-335-0260
Mailing Address - Fax:424-335-0261
Practice Address - Street 1:9667 BRIGHTON WAY
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5125
Practice Address - Country:US
Practice Address - Phone:424-335-0260
Practice Address - Fax:424-335-0261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care