MEDICARE: DR. RODNEY EBRAHIMIAN M.D.

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	208100000X	Physical Medicine & Rehabilitation Physician	A78264	CA

General Provider Information

NPI Number	:	1295880698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RODNEY EBRAHIMIAN M.D.

Provider Business Mailing Address
First Line	:	2001 S BARRINGTON AVE STE 305
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-5379
Country	:	US
Telephone Number	:	310-405-1610
Fax Number	:	310-337-0947

Provider Business Practice Location Address
First Line	:	2001 S BARRINGTON AVE STE 305
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-5379
Country	:	US
Telephone Number	:	310-666-8009
Fax Number	:	424-325-6236

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

Provider Enumeration Date	:	01/24/2007
Last Update Date	:	09/25/2023

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