MEDICARE: DR. GALIBA GAITY RAHMAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	A67092	CA

General Provider Information

NPI Number	:	1023157187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GALIBA GAITY RAHMAN M.D.

Provider Business Mailing Address
First Line	:	200 JOSE FIGUERES AVE
Second Line	:	STE 260
City	:	SAN JOSE
State	:	CA
Zip	:	95116-1555
Country	:	US
Telephone Number	:	408-223-0768
Fax Number	:	866-924-7788

Provider Business Practice Location Address
First Line	:	200 JOSE FIGUERES AVE
Second Line	:	STE 260
City	:	SAN JOSE
State	:	CA
Zip	:	95116-1555
Country	:	US
Telephone Number	:	408-258-8050
Fax Number	:	408-258-2269

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	06/11/2016

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