Provider Demographics
NPI:1609068956
Name:RAHMAN, SMAILA TIPU (SMAILA RAHMAN)
Entity Type:Individual
Prefix:DR
First Name:SMAILA
Middle Name:TIPU
Last Name:RAHMAN
Suffix:
Gender:F
Credentials:SMAILA RAHMAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4735 SEPULVEDA BLVD
Mailing Address - Street 2:APT 221
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-5418
Mailing Address - Country:US
Mailing Address - Phone:818-620-2986
Mailing Address - Fax:
Practice Address - Street 1:4735 SEPULVEDA BLVD
Practice Address - Street 2:APT 221
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-5418
Practice Address - Country:US
Practice Address - Phone:818-620-2986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA99091207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine