Provider Demographics
NPI:1205902202
Name:RAHBAN, SAID (MD)
Entity type:Individual
Prefix:
First Name:SAID
Middle Name:
Last Name:RAHBAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SAID
Other - Middle Name:
Other - Last Name:RAHBAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:6333 WILSHIRE BOULEVARD
Mailing Address - Street 2:SUITE #414
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048
Mailing Address - Country:US
Mailing Address - Phone:323-852-1751
Mailing Address - Fax:323-852-1099
Practice Address - Street 1:6333 WILSHIRE BOULEVARD
Practice Address - Street 2:SUITE #414
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048
Practice Address - Country:US
Practice Address - Phone:323-852-1751
Practice Address - Fax:323-852-1099
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA26769207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A267690Medicaid
A24955Medicare UPIN
CA00A267690Medicaid