Individual
IDA RASTEGAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
14445 OLIVE VIEW DR, DEPT OB/GYN 2B158, SYLMAR, CA 91342-1437
(818) 364-3222
Mailing address
2600 30TH ST STE 100, BOULDER, CO 80301-1237
(303) 444-0664
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
A96030
CA
207V00000X
Obstetrics & Gynecology Physician
Primary
DR52958
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DR052958
MEDICAL LICENSE
CO
Enumeration date
11/02/2006
Last updated
01/11/2023
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