Provider Demographics
NPI:1467426478
Name:RAHMAN, NADEEM U (MD)
Entity type:Individual
Prefix:
First Name:NADEEM
Middle Name:U
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 1:782 MEDICAL CENER DRIVE E SUITE 361
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611
Mailing Address - Country:US
Mailing Address - Phone:559-472-4606
Mailing Address - Fax:559-472-4608
Practice Address - Street 1:782 MEDICAL CENTER DRIVE E SUITE 311
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611
Practice Address - Country:US
Practice Address - Phone:559-472-4606
Practice Address - Fax:559-472-4608
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-15
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA74920208800000X
AZ33530208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGG694AMedicaid
CAZZZ02592ZOtherVALLEY UROLOGY MEDICARE PTAN
CACA334602Medicaid