Healthcare Provider Details

I. General information

NPI: 1063258713
Provider Name (Legal Business Name): ATA SOLEIMANI RAHBAR MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2024
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HOSPITAL CIR
WESTMINSTER CA
92683-3910
US

IV. Provider business mailing address

6230 IRVINE BLVD # 423
IRVINE CA
92620-2103
US

V. Phone/Fax

Practice location:
  • Phone: 714-893-4541
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ATA SOLEIMANI RAHBAR
Title or Position: MD/PRESIDENT
Credential: MD
Phone: 415-994-6958