Healthcare Provider Details

I. General information

NPI: 1164849253
Provider Name (Legal Business Name): MR. RABIH GEHA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2014
Last Update Date: 06/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 PARNASSUS AVE RM 987
SAN FRANCISCO CA
94143-0119
US

IV. Provider business mailing address

505 PARNASSUS AVE RM 987
SAN FRANCISCO CA
94143-0119
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-1528
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA141890
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: