Organization
OAC SOUTHERN MEDICAL PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARYAM RAHIMI D.O. (PRESIDENT)
(310) 634-1146
Entity
Organization
Contact information
Practice address
3300 W COAST HWY, SUITE A, NEWPORT BEACH, CA 92663-4007
(949) 209-0220
(949) 270-5139
Mailing address
23430 HAWTHORNE BLVD, SUITE 125, TORRANCE, CA 90505-4720
(310) 373-0555
(310) 373-5655
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
20A10143
CA
Other
Enumeration date
07/17/2012
Last updated
07/17/2012
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