MEDICARE: DR. SIMON B RAYHANABAD 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	208600000X	Surgery Physician	A36844	CA
2	2086S0129X	Vascular Surgery Physician	A36844	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	:	1710910047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SIMON B RAYHANABAD MD

Provider Business Mailing Address
First Line	:	3791 KATELLA AVE STE 201
Second Line	:
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-2016
Country	:	US
Telephone Number	:	562-596-6736
Fax Number	:	562-596-5387

Provider Business Practice Location Address
First Line	:	3791 KATELLA AVE
Second Line	:	#201
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-3105
Country	:	US
Telephone Number	:	562-596-6736
Fax Number	:	562-596-5387

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

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	05/26/2026

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Directions to “ DR. SIMON B RAYHANABAD MD” Practice Location

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