Healthcare Provider Details

I. General information

NPI: 1407942436
Provider Name (Legal Business Name): REHANA RAFIQ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 OLD RIVER RD SUITE 165
BAKERSFIELD CA
93311
US

IV. Provider business mailing address

300 OLD RIVER ROAD SUITE 165
BAKERSFIELD CA
93311
US

V. Phone/Fax

Practice location:
  • Phone: 661-663-3110
  • Fax: 661-663-3171
Mailing address:
  • Phone: 661-663-3110
  • Fax: 661-663-3171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC42416
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: