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General NPI Number Information
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NPI Number | 1639860620
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Entity Type | Organization
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Legal Business Name | VALLEY REGENERATIVE AND PAIN CLINIC
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Dates
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Enumeration Date | 05/19/2023
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 5400 BALBOA BLVD STE 141
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City | ENCINO
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State | CA
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Zip | 91316-5203
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Country | US
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Telephone | 310-759-1559
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Fax | 310-759-1560
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Provider Business Mailing Address
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Address Line | 5400 BALBOA BLVD STE 141
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City | ENCINO
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State | CA
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Zip | 91316-5203
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Country | US
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Telephone | 310-759-1559
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Fax | 310-759-1560
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Authorized Official
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Title or Position | CEO
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Name | DR. BEHNOOSH BEHDAD RAHAVARD
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Credential | MD
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Telephone | 310-759-1559
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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