Provider Demographics
NPI:1518276880
Name:ABDULRAHMAN, DIANA MOHINE (MD)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:MOHINE
Last Name:ABDULRAHMAN
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 1:2895 N TOWNE AVE
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-2009
Mailing Address - Country:US
Mailing Address - Phone:909-982-2719
Mailing Address - Fax:
Practice Address - Street 1:2895 N TOWNE AVE
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-2009
Practice Address - Country:US
Practice Address - Phone:909-982-2719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-04
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1744R1102X, 390200000X
CAA1397682084V0102X
AZ516012084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No1744R1102XOther Service ProvidersSpecialistResearch Study
No2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program