Provider Demographics
NPI:1588213029
Name:KHALEGHIFAR, MOHAMMAD (PT, DPT)
Entity type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:
Last Name:KHALEGHIFAR
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7779 SWEET RANCH CIR
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-1593
Mailing Address - Country:US
Mailing Address - Phone:909-283-9966
Mailing Address - Fax:
Practice Address - Street 1:851 E 6TH ST STE A4
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:CA
Practice Address - Zip Code:92223-2371
Practice Address - Country:US
Practice Address - Phone:909-756-7001
Practice Address - Fax:951-381-1122
Is Sole Proprietor?:No
Enumeration Date:2019-09-07
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA296809225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist