Active NPI
Nikou Rahbar
- General Practice Dentistry
- San Diego, CA
National Provider Identifier
1467736520
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 60641
- Practice address
- 1333 Camino del Rio S
Suite 202
San Diego, CA 92108-3520 - Phone
- (949) 903-3525
- NPI assigned
- Oct 6, 2011
- Last updated
- Jan 3, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 60641 | CA | Primary |
Addresses
Primary practice location
1333 Camino del Rio S
Suite 202
San Diego, CA 92108-3520
Mailing address
1333 Camino del Rio S
Suite 202
San Diego, CA 92108-3520
Phone (949) 903-3525
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160212000771 | CA | Order and Referring Only - Oral Surgery | 8527362458 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60641 | CA | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357171200000",
"number": "1467736520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1333 CAMINO DEL RIO S",
"address_2": "SUITE 202",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921083520",
"telephone_number": "949-903-3525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1333 CAMINO DEL RIO S",
"address_2": "SUITE 202",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921083520",
"telephone_number": "949-903-3525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAHBAR",
"first_name": "NIKOU",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-10-06",
"last_updated": "2013-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "60641",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.