Provider Demographics
NPI:1598728990
Name:RAHMAN, HABIB (MD)
Entity Type:Individual
Prefix:DR
First Name:HABIB
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 1:26691 PLAZA SUITE 150
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6329
Mailing Address - Country:US
Mailing Address - Phone:949-276-2882
Mailing Address - Fax:949-276-2885
Practice Address - Street 1:26691 PLAZA SUITE 150
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691
Practice Address - Country:US
Practice Address - Phone:949-276-2882
Practice Address - Fax:949-276-2885
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2018-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA063719207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORH1352Medicare UPIN
CAWA63719AMedicare ID - Type Unspecified