| Doctor Name: | DR. YASHA RASTGAR |
| NPI Number: | 1003270745 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | |
| Business Practice Address: | 1 Medical Center Drive Box 9137 Morgantown, WV - 26506 |
| Business Phone Number: | 3042935323 |
| Business Fax Number: | 3042938724 |
| Mailing Address: | 950 25th St Nw, Apt 209 South WASHINGTON |
| State: | DC |
| Postal Code: | 200372137 |
| Phone Number: | 6094423509 |
| Fax Number: | |
| NPI Enumeration Date: | 04/08/2016 |
| NPI Last Update Date: | 04/08/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |