Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | D45961 | CA |
N | 1223G0001X | General Practice | D45961 | CA |
N | 213EG0000X | General Practice | D45961 | CA |
NPI | 1003898693 |
---|---|
Provider Name | Dr. Sohrab Rahbar |
First Address | Irvine, CA 92604-4805 |
Second Address | Irvine, CA 92604-4791 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2005 |
Last Update Date | 08/07/2007 |