Provider Demographics
NPI:1912128034
Name:RAHNAMOON, HADI (MD)
Entity type:Individual
Prefix:
First Name:HADI
Middle Name:
Last Name:RAHNAMOON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28882 WESTPORT WAY
Mailing Address - Street 2:
Mailing Address - City:LAGUNA MIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677
Mailing Address - Country:US
Mailing Address - Phone:949-716-5857
Mailing Address - Fax:
Practice Address - Street 1:1212 PICO ST
Practice Address - Street 2:SAN FERNANDO HEALTH CENTER
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340
Practice Address - Country:US
Practice Address - Phone:818-837-6969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38623207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology