MEDICARE: SOHRAB RUSTOM IRANI M.D.

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	207V00000X	Obstetrics & Gynecology Physician	91-71	NM
2	207V00000X	Obstetrics & Gynecology Physician	01037526A	IN
3	207V00000X	Obstetrics & Gynecology Physician	6938716-1205	UT
4	207V00000X	Obstetrics & Gynecology Physician	25828	KY
5	207V00000X	Obstetrics & Gynecology Physician	6219	NV

General Provider Information

NPI Number	:	1144225384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOHRAB RUSTOM IRANI M.D.

Provider Business Mailing Address
First Line	:	PO BOX 12388
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89112-0388
Country	:	US
Telephone Number	:	702-456-5433
Fax Number	:	702-456-6052

Provider Business Practice Location Address
First Line	:	4455 NEWELL DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-5786
Country	:	US
Telephone Number	:	702-456-5433
Fax Number	:	702-456-6052

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	05/04/2009

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