Provider Demographics
NPI:1912761503
Name:SURAIYA RAHMAN MEDICAL CORPORATION
Entity Type:Organization
Organization Name:SURAIYA RAHMAN MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SURAIYA
Authorized Official - Middle Name:SIMI
Authorized Official - Last Name:RAHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-808-4080
Mailing Address - Street 1:243 WALLIS ST UNIT 4
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-5419
Mailing Address - Country:US
Mailing Address - Phone:626-278-8727
Mailing Address - Fax:
Practice Address - Street 1:959 E WALNUT ST STE 214
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-5361
Practice Address - Country:US
Practice Address - Phone:626-808-4080
Practice Address - Fax:626-669-4080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty