Provider Demographics
NPI:1053706283
Name:RAHBAR, GELAREH (DDS)
Entity type:Individual
Prefix:
First Name:GELAREH
Middle Name:
Last Name:RAHBAR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 LAKESHORE AVE APT 18H
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94606-1629
Mailing Address - Country:US
Mailing Address - Phone:415-385-5775
Mailing Address - Fax:415-276-6370
Practice Address - Street 1:133 KEARNY ST STE 204
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-4809
Practice Address - Country:US
Practice Address - Phone:415-986-7100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-03
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42765122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist