Healthcare Provider Details

I. General information

NPI: 1447730205
Provider Name (Legal Business Name): SABEENA RAHMAN RAZA PHARM. D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2018
Last Update Date: 08/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

795 EL CAMINO REAL
PALO ALTO CA
94301-2302
US

IV. Provider business mailing address

9898 MONTEGRINO CT
ELK GROVE CA
95757-3066
US

V. Phone/Fax

Practice location:
  • Phone: 650-853-6066
  • Fax:
Mailing address:
  • Phone: 916-501-3877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number78002
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: