Healthcare Provider Details

I. General information

NPI: 1629085774
Provider Name (Legal Business Name): DARREN A RAHAMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 05/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1799 MOUNT MARIAH DRIVE
LAS VEGAS NV
89106-1501
US

IV. Provider business mailing address

3325 RESEARCH WAY
CARSON CITY NV
89706-7913
US

V. Phone/Fax

Practice location:
  • Phone: 702-383-1961
  • Fax: 702-319-6147
Mailing address:
  • Phone: 775-888-6610
  • Fax: 775-888-4904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number9433
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: