Healthcare Provider Details

I. General information

NPI: 1033310883
Provider Name (Legal Business Name): USMAN G RAHIM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: USMAN G RAHIM PA

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 06/06/2023
Certification Date: 06/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 THE CITY DR S BLDG 22
ORANGE CA
92868-3201
US

IV. Provider business mailing address

200 S MANCHESTER AVE STE 300
ORANGE CA
92868-3219
US

V. Phone/Fax

Practice location:
  • Phone: 888-717-4463
  • Fax:
Mailing address:
  • Phone: 714-456-2986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2014
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number036156495
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberA140939
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: