MEDICARE: DR. ABRAHAM T RASUL JR. 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	208100000X	Physical Medicine & Rehabilitation Physician	MD30221	DC
2	208100000X	Physical Medicine & Rehabilitation Physician	C51132	CA

General Provider Information

NPI Number	:	1750328647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ABRAHAM T RASUL JR. M.D.

Provider Business Mailing Address
First Line	:	1555 HIGUERA ST
Second Line	:
City	:	SAN LUIS OBISPO
State	:	CA
Zip	:	93401-2917
Country	:	US
Telephone Number	:	805-541-2368
Fax Number	:	805-541-2553

Provider Business Practice Location Address
First Line	:	1555 HIGUERA ST
Second Line	:
City	:	SAN LUIS OBISPO
State	:	CA
Zip	:	93401-2917
Country	:	US
Telephone Number	:	805-541-2368
Fax Number	:	805-541-2553

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

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	11/03/2023

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