MEDICARE: HOUMAN RAHNAMA DDS, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center	40979	CA

General Provider Information

NPI Number	:	1013066687
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOUMAN RAHNAMA DDS, INC

Provider Business Mailing Address
First Line	:	28940 GOLDEN LANTERN
Second Line	:	#H
City	:	LAGUNA NIGUEL
State	:	CA
Zip	:	92677-1500
Country	:	US
Telephone Number	:	949-363-2010
Fax Number	:

Provider Business Practice Location Address
First Line	:	28940 GOLDEN LANTERN
Second Line	:	#H
City	:	LAGUNA NIGUEL
State	:	CA
Zip	:	92677-1500
Country	:	US
Telephone Number	:	949-363-2010
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. HOUMAN RAHNAMA
Credential	:	DDS
Telephone Number	:	949-363-2010

Provider Enumeration Date	:	01/10/2007
Last Update Date	:	04/29/2013

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