Provider Demographics
NPI:1639106628
Name:RAHIMIAN, SHEIDA (RPT)
Entity type:Individual
Prefix:
First Name:SHEIDA
Middle Name:
Last Name:RAHIMIAN
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11550 INDIAN HILLS ROAD
Mailing Address - Street 2:SUITE 241
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91345
Mailing Address - Country:US
Mailing Address - Phone:818-361-0136
Mailing Address - Fax:818-365-1259
Practice Address - Street 1:11550 INDIAN HILLS RD
Practice Address - Street 2:SUITE 241
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-1200
Practice Address - Country:US
Practice Address - Phone:818-361-0136
Practice Address - Fax:818-365-1259
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT18903225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT18903BMedicare PIN
CAQ57022Medicare UPIN