Provider Demographics
NPI:1922591155
Name:KATBAMNA, RAHUL YOGEE (MED, ATC, CES, PES)
Entity Type:Individual
Prefix:
First Name:RAHUL
Middle Name:YOGEE
Last Name:KATBAMNA
Suffix:
Gender:M
Credentials:MED, ATC, CES, PES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 LYNNFIELD
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-1987
Mailing Address - Country:US
Mailing Address - Phone:949-241-3682
Mailing Address - Fax:
Practice Address - Street 1:15 LYNNFIELD
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92620-1987
Practice Address - Country:US
Practice Address - Phone:949-241-3682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-12
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA29822081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine