Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | A51095 | CA |
NPI | 1003924168 |
---|---|
Provider Name | Alfred Rahban |
First Address | Los Angeles, CA 90036-4667 |
Second Address | Los Angeles, CA 90036-4667 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 02/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003924168 | (05) | CA |