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General NPI Number Information
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NPI Number | 1366144438
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Entity Type | Organization
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Legal Business Name | ALIREZA RABOUBI, MD, INC
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Dates
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Enumeration Date | 03/21/2023
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Last Update Date | 03/21/2023
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Provider Practice Location Address
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Address Line | 23679 RIDGEWAY
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City | MISSION VIEJO
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State | CA
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Zip | 92677
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Country | US
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Telephone | 818-491-8533
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Fax |
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Provider Business Mailing Address
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Address Line | 30025 ALICIA PKWY # 122
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-2090
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Country | US
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Telephone | 818-491-8533
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. ALIREZA RABOUBI
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Credential | MD
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Telephone | 818-491-8533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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