Healthcare Provider Details

I. General information

NPI: 1316096811
Provider Name (Legal Business Name): KHURRAM SHAMIM REHMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 02/27/2024
Certification Date: 02/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5320 S RAINBOW BLVD
LAS VEGAS NV
89118-1895
US

IV. Provider business mailing address

5320 S RAINBOW BLVD
LAS VEGAS NV
89118-1895
US

V. Phone/Fax

Practice location:
  • Phone: 702-935-4936
  • Fax: 702-892-9666
Mailing address:
  • Phone: 702-935-4936
  • Fax: 702-892-9666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number25221
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number13814381-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: