Healthcare Provider Details

I. General information

NPI: 1992816136
Provider Name (Legal Business Name): SHERVIN RAHMANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 12/01/2020
Certification Date: 12/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6005 PARK AVE SUITE 728B
MEMPHIS TN
38119
US

IV. Provider business mailing address

6005 PARK AVE SUITE 728B
MEMPHIS TN
38119
US

V. Phone/Fax

Practice location:
  • Phone: 901-761-9097
  • Fax: 901-682-7635
Mailing address:
  • Phone: 901-761-9097
  • Fax: 901-682-7635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License NumberA67716
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: