Provider Demographics
NPI:1447470554
Name:RAHMAN, MAHFUZUR (MD)
Entity type:Individual
Prefix:
First Name:MAHFUZUR
Middle Name:
Last Name:RAHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8349 RESEDA BLVD
Mailing Address - Street 2:SUITE G
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-4622
Mailing Address - Country:US
Mailing Address - Phone:818-585-5678
Mailing Address - Fax:818-775-9351
Practice Address - Street 1:8349 RESEDA BLVD
Practice Address - Street 2:SUITE G
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-4622
Practice Address - Country:US
Practice Address - Phone:818-585-5678
Practice Address - Fax:818-775-9351
Is Sole Proprietor?:No
Enumeration Date:2007-04-30
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA116452207RN0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine