Healthcare Provider Details

I. General information

NPI: 1346233434
Provider Name (Legal Business Name): AFSHIN DAVID RAHIMI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: AFSHIN RAHIMIZADEH MD

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 02/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6333 WILSHIRE BLVD STE 409 STE 200
LOS ANGELES CA
90048-5722
US

IV. Provider business mailing address

6333 WILSHIRE BLVD STE 409 STE 200
LOS ANGELES CA
90048-5722
US

V. Phone/Fax

Practice location:
  • Phone: 323-653-7700
  • Fax: 323-653-6409
Mailing address:
  • Phone: 323-653-7700
  • Fax: 323-653-6409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberA63668
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: