MEDICARE: REHANA S. BAQAI 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	174400000X	Specialist	A48182	CA
2	207RH0003X	Hematology & Oncology Physician	A48182	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	ZZZ64478Z	OTHER	BLUE SHIELD
2	ZZZ05040Z	OTHER	BLUE SHEILD
4	ZZZ05039Z	OTHER	BLUE SHIELD
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164478855
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REHANA S. BAQAI M.D.

Provider Business Mailing Address
First Line	:	18111 BROOKHURST ST
Second Line	:	SUITE # 6100
City	:	FOUNTAIN VALLEY
State	:	CA
Zip	:	92708-6728
Country	:	US
Telephone Number	:	714-698-0300
Fax Number	:	714-698-0313

Provider Business Practice Location Address
First Line	:	260 E ONTARIO AVE
Second Line	:	SUITE # 101
City	:	CORONA
State	:	CA
Zip	:	92879-3506
Country	:	US
Telephone Number	:	951-371-2411
Fax Number	:	951-284-0177

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

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	09/21/2023

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