Provider Demographics
NPI:1114396371
Name:RAHAVARD, BEHNOOSH BEHDAD (MD)
Entity type:Individual
Prefix:DR
First Name:BEHNOOSH
Middle Name:BEHDAD
Last Name:RAHAVARD
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 BALBOA BLVD STE 141
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-5203
Mailing Address - Country:US
Mailing Address - Phone:310-759-1559
Mailing Address - Fax:
Practice Address - Street 1:5400 BALBOA BLVD STE 141
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-5203
Practice Address - Country:US
Practice Address - Phone:310-759-1559
Practice Address - Fax:310-759-1560
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-17
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA167634207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology