MEDICARE: DR. HOUMAN DAHI 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	207RP1001X	Pulmonary Disease Physician	A98386	CA
2	207RS0012X	Sleep Medicine (Internal Medicine) Physician	A98386	CA
3	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	A98386	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A98386	OTHER	CA	CA MEDICAL LICENSE
2	11175012	OTHER	CA	CAQH

General Provider Information

NPI Number	:	1598732604
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HOUMAN DAHI MD

Provider Business Mailing Address
First Line	:	501 WASHINGTON ST STE 508
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-2231
Country	:	US
Telephone Number	:	619-299-2570
Fax Number	:	619-294-2738

Provider Business Practice Location Address
First Line	:	501 WASHINGTON ST STE 508
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-2231
Country	:	US
Telephone Number	:	619-299-2570
Fax Number	:	619-294-2738

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

Provider Enumeration Date	:	03/07/2006
Last Update Date	:	02/04/2015

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