Healthcare Provider Details

I. General information

NPI: 1467195826
Provider Name (Legal Business Name): JABRIL ABDUL-RASHED PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2022
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2395 LOMBARD ST
SAN FRANCISCO CA
94123-2601
US

IV. Provider business mailing address

3450 UNION RD
CHEEKTOWAGA NY
14225-5120
US

V. Phone/Fax

Practice location:
  • Phone: 415-796-2242
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9115705
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA218276
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number65630
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: