Provider Demographics
NPI:1124246293
Name:ROOHPARVAR MEDICAL COPORATION
Entity type:Organization
Organization Name:ROOHPARVAR MEDICAL COPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAHAB
Authorized Official - Middle Name:
Authorized Official - Last Name:ROOHPARVAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-969-9101
Mailing Address - Street 1:2660 GRANT RD
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-4315
Mailing Address - Country:US
Mailing Address - Phone:650-969-9101
Mailing Address - Fax:
Practice Address - Street 1:2660 GRANT RD
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4315
Practice Address - Country:US
Practice Address - Phone:650-969-9101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG081901207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF70324Medicare UPIN
CA00G530020Medicare ID - Type Unspecified