Provider Demographics
NPI:1265547418
Name:RAHBAR, NASER (MD)
Entity type:Individual
Prefix:DR
First Name:NASER
Middle Name:
Last Name:RAHBAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:NASROLLAH
Other - Middle Name:
Other - Last Name:RAHBAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 646
Mailing Address - Street 2:
Mailing Address - City:STANTON
Mailing Address - State:CA
Mailing Address - Zip Code:90680-0646
Mailing Address - Country:US
Mailing Address - Phone:562-809-3568
Mailing Address - Fax:
Practice Address - Street 1:3033 W ORANGE AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-3156
Practice Address - Country:US
Practice Address - Phone:714-229-4060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA803242085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A803240Medicaid
CAWA80324BMedicare PIN
CAH31615Medicare UPIN
CA00A803240Medicaid