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NPI Code Detail

MEDICARE: IRAN RAHBAR RN, PHN, CSN

MEDICARE: IRAN RAHBAR RN, PHN, CSN
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
1364SC1501XCommunity Health/Public Health Clinical Nurse SpecialistPHN551503CA
2163WS0200XSchool Registered NurseRN95099045CA

General Provider Information

NPI Number : 1720872906
Entity Type Code : Individual
Provider Name (Legal Business Name) : IRAN RAHBAR RN, PHN, CSN
Provider Business Mailing Address
First Line : 4048 HILLTOP RD APT B
Second Line :
City : SANTA MARIA
State : CA
Zip : 93455-6449
Country : US
Telephone Number : 805-406-1687
Fax Number :
Provider Business Practice Location Address
First Line : 500 DYER ST
Second Line :
City : ORCUTT
State : CA
Zip : 93455-5300
Country : US
Telephone Number : 805-938-8989
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2025
Last Update Date : 04/10/2025

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