| Maryam Rahnemun Md Inc | |
|
14150 Culver Dr Ste 105 Irvine CA 92604-0322 | |
| (949) 612-6050 | |
| Not Available |
| Full Name | Maryam Rahnemun Md Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 14150 Culver Dr Ste 105, Irvine, California |
| Authorized Official Name and Position | Maryam Rahnemum (PRESIDENT) |
| Authorized Official Contact | 7145471700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maryam Rahnemun Md Inc Po Box 18588 Irvine CA 92623-8588 Ph: (714) 547-1700 | Maryam Rahnemun Md Inc 14150 Culver Dr Ste 105 Irvine CA 92604-0322 Ph: (949) 612-6050 |
| NPI Number | 1932260106 |
|---|---|
| Provider Enumeration Date | 12/12/2006 |
| Last Update Date | 10/08/2019 |
| Medicare PECOS PAC ID | 6800814849 |
|---|---|
| Medicare Enrollment ID | O20051108000404 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932260106 | NPI | - | NPPES |
| W19308 | Medicaid | CA | |
| 00A533771 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A53377 (California) | Primary |
| Provider Name | Maryam Rahnemun |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114921673 PECOS PAC ID: 2062441264 Enrollment ID: I20050808001210 |
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