MEDICARE: MOHSEN TAHANI MD

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	208100000X	Physical Medicine & Rehabilitation Physician	262262	NY
2	208100000X	Physical Medicine & Rehabilitation Physician	3334618	NY
3	208100000X	Physical Medicine & Rehabilitation Physician	A138468	CA
4	208100000X	Physical Medicine & Rehabilitation Physician	04-36758	KS
5	208100000X	Physical Medicine & Rehabilitation Physician	2016026450	MO

General Provider Information

NPI Number	:	1235441619
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHSEN TAHANI MD

Provider Business Mailing Address
First Line	:	4125 STATE LINE RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-4423
Country	:	US
Telephone Number	:	816-655-5270
Fax Number	:	816-655-5395

Provider Business Practice Location Address
First Line	:	801 NW SAINT MARY DR STE 210
Second Line	:
City	:	BLUE SPRINGS
State	:	MO
Zip	:	64014-2539
Country	:	US
Telephone Number	:	818-300-2998
Fax Number	:

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

Provider Enumeration Date	:	07/13/2010
Last Update Date	:	06/19/2019

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