Healthcare Provider Details

I. General information

NPI: 1245898253
Provider Name (Legal Business Name): RASHA GAMALELDIN ELBADRY AHMED M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2019
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date: 03/15/2023
Reactivation Date: 05/26/2023

III. Provider practice location address

11234 ANDERSON STREET WESTERLY STE C
LOMA LINDA CA
92354
US

IV. Provider business mailing address

11234 ANDERSON STREET WESTERLY STE C
LOMA LINDA CA
92354
US

V. Phone/Fax

Practice location:
  • Phone: 909-558-6131
  • Fax: 720-777-7272
Mailing address:
  • Phone: 909-558-6131
  • Fax: 720-777-7272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberPTL8390
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: