Healthcare Provider Details

I. General information

NPI: 1437134319
Provider Name (Legal Business Name): NAZIR AHMAD RAHIM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 02/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1580 CREEKSIDE DR STE 220
FOLSOM CA
95630-3886
US

IV. Provider business mailing address

1580 CREEKSIDE DR STE 220
FOLSOM CA
95630-3886
US

V. Phone/Fax

Practice location:
  • Phone: 916-983-4444
  • Fax: 530-295-4104
Mailing address:
  • Phone: 916-983-4444
  • Fax: 530-295-4104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberA77214
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License NumberA77214
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: