Provider Demographics
NPI:1982024246
Name:KHAJEH, RAHIM (MD)
Entity Type:Individual
Prefix:
First Name:RAHIM
Middle Name:
Last Name:KHAJEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 E SPEEDWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-3917
Mailing Address - Country:US
Mailing Address - Phone:520-833-5171
Mailing Address - Fax:520-276-2829
Practice Address - Street 1:7510 N ORACLE RD STE 100
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-4447
Practice Address - Country:US
Practice Address - Phone:520-324-4910
Practice Address - Fax:520-324-4491
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-24
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
AZ54512207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program