Healthcare Provider Details

I. General information

NPI: 1801475322
Provider Name (Legal Business Name): RAFA IFTHIKHAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2021
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 PORTRERO AVE
SAN FRANCISCO CA
94110-3518
US

IV. Provider business mailing address

1001 PORTRERO AVE BUILDING 5, UNIT 6D
SAN FRANCISCO CA
94110-3518
US

V. Phone/Fax

Practice location:
  • Phone: 628-206-8358
  • Fax:
Mailing address:
  • Phone: 858-249-1206
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA195701
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: