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Organization

OAC SOUTHERN MEDICAL PROFESSIONAL CORP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARYAM RAHIMI D.O. (DOCTOR)
(310) 373-0555
Entity
Organization

Contact information

Practice address
23430 HAWTHORNE BLVD, 125, TORRANCE, CA 90505-4720
(310) 373-0555
(310) 373-5655
Mailing address
23430 HAWTHORNE BLVD, 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
005474
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
20A10143
CA LICENSE
CA
Enumeration date
08/08/2011
Last updated
07/16/2012
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