MEDICARE: DR. ALI R RAHIMI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	037050	GA
2	207R00000X	Internal Medicine Physician	15970	NV

General Provider Information

NPI Number	:	1033103908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALI R RAHIMI MD

Provider Business Mailing Address
First Line	:	3150 N TENAYA WAY
Second Line	:	STE 480
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0443
Country	:	US
Telephone Number	:	702-562-5765
Fax Number	:	855-327-1927

Provider Business Practice Location Address
First Line	:	3150 N TENAYA WAY
Second Line	:	SUITE 271
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0443
Country	:	US
Telephone Number	:	702-562-5765
Fax Number	:	855-327-1927

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	08/21/2015

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