MEDICARE: QASIM RAHMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	A183547	CA
2	390200000X	Student in an Organized Health Care Education/Training Program
3	390200000X	Student in an Organized Health Care Education/Training Program		NM

General Provider Information

NPI Number	:	1861953796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	QASIM RAHMAN

Provider Business Mailing Address
First Line	:	31700 TEMECULA PKWY STE 2
Second Line	:
City	:	TEMECULA
State	:	CA
Zip	:	92592-5896
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	MSC10 6660 1 UNIVERSITY OF NEW MEXICO
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87131-0001
Country	:	US
Telephone Number	:	505-272-2610
Fax Number	:	505-272-1300

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2019
Last Update Date	:	04/20/2026

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