MEDICARE: DR. HOUMAN RAHNAMA 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	1223G0001X	General Practice Dentistry	40979	CA

General Provider Information

NPI Number	:	1851398010
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HOUMAN RAHNAMA DDS

Provider Business Mailing Address
First Line	:	28940 GOLDEN LANTERN
Second Line	:	#H
City	:	LAGUNA NIGUEL
State	:	CA
Zip	:	92677-1500
Country	:	US
Telephone Number	:	949-363-2010
Fax Number	:	949-363-2085

Provider Business Practice Location Address
First Line	:	28940 GOLDEN LANTERN
Second Line	:	#H
City	:	LAGUNA NIGUEL
State	:	CA
Zip	:	92677-1500
Country	:	US
Telephone Number	:	949-363-2010
Fax Number	:	949-363-2085

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

Provider Enumeration Date	:	07/02/2005
Last Update Date	:	07/08/2007

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