Provider Demographics
NPI:1780606061
Name:RAHBAR, FARSHID SAM (MD, FACP)
Entity type:Individual
Prefix:DR
First Name:FARSHID
Middle Name:SAM
Last Name:RAHBAR
Suffix:
Gender:M
Credentials:MD, FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2080 CENTURY PARK E
Mailing Address - Street 2:SUITE1804
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90067-2001
Mailing Address - Country:US
Mailing Address - Phone:310-553-4400
Mailing Address - Fax:310-553-5590
Practice Address - Street 1:2080 CENTURY PARK E
Practice Address - Street 2:SUITE1804
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90067-2001
Practice Address - Country:US
Practice Address - Phone:310-553-4400
Practice Address - Fax:310-553-5590
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38265207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA38265OtherBLUE CROSS PROVIDER NUMBE
CA00A382650Medicaid
CA110131196COtherMEDICARE RAILROAD PROV NO
CA00A382650OtherBLUE SHIELD PROVIDER NUMB
CAA38265OtherSTATE LICENSE
CA110131196COtherMEDICARE RAILROAD PROV NO
CAA38265OtherSTATE LICENSE