Healthcare Provider Details

I. General information

NPI: 1487929972
Provider Name (Legal Business Name): RAHMAT BALOGUN D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2012
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 POST STREET SUITE 460
SAN FRANCISCO CA
49115
US

IV. Provider business mailing address

2330 POST STREET SUITE 460
SAN FRANCISCO CA
49115
US

V. Phone/Fax

Practice location:
  • Phone: 415-221-4810
  • Fax:
Mailing address:
  • Phone: 415-221-4810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number14037
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number271433
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License Number20A14037
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: