Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 20A7914 | CA |
NPI | 1326075235 |
---|---|
Provider Name | Mr. Imad Mohamed Rashid |
First Address | Roseville, CA 95678-0685 |
Second Address | Roseville, CA 95661 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H02424 | (02) |