MEDICARE: PARVIZ RAHIMZADEH DDS

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	122300000X	Dentist	55923	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255515102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PARVIZ RAHIMZADEH DDS

Provider Business Mailing Address
First Line	:	6035 BRISTOL PKWY
Second Line	:	SUITE 200
City	:	CULVER CITY
State	:	CA
Zip	:	90230-6601
Country	:	US
Telephone Number	:	800-373-5400
Fax Number	:

Provider Business Practice Location Address
First Line	:	6035 BRISTOL PKWY
Second Line	:	SUITE 200
City	:	CULVER CITY
State	:	CA
Zip	:	90230-6601
Country	:	US
Telephone Number	:	800-373-5400
Fax Number	:

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

Provider Enumeration Date	:	12/27/2007
Last Update Date	:	12/27/2007

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