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NPI Code Detail

MEDICARE: SAHAR MUSTAFA ABDELRAHMAN MD

MEDICARE: SAHAR MUSTAFA ABDELRAHMAN MD
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
1207R00000XInternal Medicine PhysicianA117193CA
2208000000XPediatrics PhysicianA117193CA

General Provider Information

NPI Number : 1194013417
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAHAR MUSTAFA ABDELRAHMAN MD
Provider Business Mailing Address
First Line : 5849 CROCKER ST
Second Line : UNIT K
City : LOS ANGELES
State : CA
Zip : 90003-1311
Country : US
Telephone Number : 323-406-5800
Fax Number : 323-233-2685
Provider Business Practice Location Address
First Line : 711 W FLORENCE AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90044-6105
Country : US
Telephone Number : 323-789-5610
Fax Number : 323-789-5616
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2011
Last Update Date : 09/10/2015

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