Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 12404232-1205 | UT |
NPI | 1033543541 |
---|---|
Provider Name | Mr. Shervin Rahimpour |
First Address | Colorado Springs, CO 80918-8167 |
Second Address | Colorado Springs, CO 80918-8167 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2013 |
Last Update Date | 12/11/2021 |