Provider Demographics
NPI:1922150721
Name:RANGINWALA, MOHAMMAD H (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:H
Last Name:RANGINWALA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MUHAMMAD
Other - Middle Name:H
Other - Last Name:RANGINWALA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1011 SNEATH LN
Mailing Address - Street 2:
Mailing Address - City:SAN BRUNO
Mailing Address - State:CA
Mailing Address - Zip Code:94066-2311
Mailing Address - Country:US
Mailing Address - Phone:650-742-2000
Mailing Address - Fax:
Practice Address - Street 1:1011 SNEATH LN
Practice Address - Street 2:
Practice Address - City:SAN BRUNO
Practice Address - State:CA
Practice Address - Zip Code:94066-2311
Practice Address - Country:US
Practice Address - Phone:650-742-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA88232207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
00A882320Medicare ID - Type Unspecified
CA00A882320Medicaid
I43260Medicare UPIN