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General NPI Number Information
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NPI Number | 1093672321
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Entity Type | Organization
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Legal Business Name | REEMA MEDICAL GROUP OF KANSAS PA
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Dates
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Enumeration Date | 01/08/2026
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 4601 E DOUGLAS AVE STE 150
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City | WICHITA
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State | KS
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Zip | 67218-1011
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Country | US
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Telephone | 612-356-2582
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Fax |
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Provider Business Mailing Address
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Address Line | 2708 E LAKE ST UNIT 302
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City | MINNEAPOLIS
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State | MN
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Zip | 55406-1928
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Country | US
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Telephone | 612-356-2582
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | YAVAR MOGHIMI
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Credential | MD
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Telephone | 612-356-2582
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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