Provider Demographics
NPI:1659708295
Name:FAHIMI, RAHA IDA (OD)
Entity type:Individual
Prefix:DR
First Name:RAHA
Middle Name:IDA
Last Name:FAHIMI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6410 ROCKLEDGE DR STE 104
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-7819
Mailing Address - Country:US
Mailing Address - Phone:301-897-8484
Mailing Address - Fax:
Practice Address - Street 1:6410 ROCKLEDGE DR STE 104
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-7819
Practice Address - Country:US
Practice Address - Phone:301-897-8484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-27
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34405152W00000X
MDTA2386152W00000X
NJ27OA00650700152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist