Provider Demographics
NPI:1407942436
Name:RAFIQ, REHANA (MD)
Entity Type:Individual
Prefix:DR
First Name:REHANA
Middle Name:
Last Name:RAFIQ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 OLD RIVER ROAD
Mailing Address - Street 2:SUITE 165
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311
Mailing Address - Country:US
Mailing Address - Phone:661-663-3110
Mailing Address - Fax:661-663-3171
Practice Address - Street 1:300 OLD RIVER RD
Practice Address - Street 2:SUITE 165
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311
Practice Address - Country:US
Practice Address - Phone:661-663-3110
Practice Address - Fax:661-663-3171
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC42416208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
E25331Medicare UPIN