Healthcare Provider Details

I. General information

NPI: 1710064365
Provider Name (Legal Business Name): SOLEYMAN ROKHSAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11301 WILSHIRE BLVD
LOS ANGELES CA
90073-1003
US

IV. Provider business mailing address

222 S HAMILTON DR APT B
BEVERLY HILLS CA
90211-3404
US

V. Phone/Fax

Practice location:
  • Phone: 310-268-3125
  • Fax:
Mailing address:
  • Phone: 323-852-4750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA068984
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: