Healthcare Provider Details

I. General information

NPI: 1225664527
Provider Name (Legal Business Name): ISABEL RAHBAR NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2020
Last Update Date: 03/18/2020
Certification Date: 03/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1031 W 34TH ST
LOS ANGELES CA
90089-3602
US

IV. Provider business mailing address

1031 W 34TH ST
LOS ANGELES CA
90089-3602
US

V. Phone/Fax

Practice location:
  • Phone: 213-740-8318
  • Fax:
Mailing address:
  • Phone: 213-740-8318
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number95014229
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: