Healthcare Provider Details

I. General information

NPI: 1770044299
Provider Name (Legal Business Name): ARASH ATABAK RAHIMI-ARDABILY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2019
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 MAGNOLIA AVE
RIVERSIDE CA
92504-3849
US

IV. Provider business mailing address

7300 MAGNOLIA AVE
RIVERSIDE CA
92504-3849
US

V. Phone/Fax

Practice location:
  • Phone: 888-754-0626
  • Fax:
Mailing address:
  • Phone: 888-754-0626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD484889
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: