Provider Demographics
NPI:1639919921
Name:VOHOUMANI, ROSTAM (DO)
Entity type:Individual
Prefix:
First Name:ROSTAM
Middle Name:
Last Name:VOHOUMANI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27032 BANDERAS
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6010
Mailing Address - Country:US
Mailing Address - Phone:949-922-9650
Mailing Address - Fax:
Practice Address - Street 1:14375 NASON ST
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92555-4729
Practice Address - Country:US
Practice Address - Phone:951-486-5907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-25
Last Update Date:2024-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program