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General NPI Number Information
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NPI Number | 1518036888
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Entity Type | Individual
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Provider Name | RAHIL ABDEMANNAN BANDUKWALA D.O.
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Gender | Male
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 317 N EL CAMINO REAL SUITE 201
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City | ENCINITAS
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State | CA
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Zip | 92024-2811
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Country | US
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Telephone | 760-634-0064
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Fax | 760-334-2006
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Provider Business Mailing Address
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Address Line | 10625 MONTEGO DR
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City | SAN DIEGO
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State | CA
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Zip | 92124-1908
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Country | US
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Telephone | 858-829-2385
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Fax | 858-576-0954
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 20A 7863
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License Number State | CA
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