Healthcare Provider Details

I. General information

NPI: 1669665972
Provider Name (Legal Business Name): RAHIM KARJOO MD INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2007
Last Update Date: 04/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12665 GARDEN GROVE BLVD SUITE 111
GARDEN GROVE CA
92843-1915
US

IV. Provider business mailing address

12665 GARDEN GROVE BLVD SUITE 111
GARDEN GROVE CA
92843-1901
US

V. Phone/Fax

Practice location:
  • Phone: 714-636-0261
  • Fax: 714-636-0263
Mailing address:
  • Phone: 714-636-0261
  • Fax: 714-636-0263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberC37311
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License NumberC37311
License Number StateCA

VIII. Authorized Official

Name: RAHIM KARJOO
Title or Position: OWNER/MEDICAL DIRECTOR
Credential: MD
Phone: 714-636-0261