Provider Demographics
NPI:1861458390
Name:RAHMAN, SHAHED S (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAHED
Middle Name:S
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 1:407 N PACIFIC COAST HWY STE 250
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-2872
Mailing Address - Country:US
Mailing Address - Phone:949-610-9348
Mailing Address - Fax:
Practice Address - Street 1:407 N PACIFIC COAST HWY STE 250
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-2872
Practice Address - Country:US
Practice Address - Phone:949-610-9348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-24
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA91768207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology