Provider Demographics
NPI:1780211086
Name:RAHMAN, MEGAN NICOLE (DO)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:NICOLE
Last Name:RAHMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:17742 BEACH BLVD
Mailing Address - Street 2:SUITE 360
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-6854
Mailing Address - Country:US
Mailing Address - Phone:714-848-0868
Mailing Address - Fax:714-848-2248
Practice Address - Street 1:17742 BEACH BLVD
Practice Address - Street 2:SUITE 360
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-6854
Practice Address - Country:US
Practice Address - Phone:714-848-0868
Practice Address - Fax:714-848-2248
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-25
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A210542080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine