Basic Information
| Provider Information | |||||||||
| NPI: | 1427169986 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RAHMAN | ||||||||
| FirstName: | SYED | ||||||||
| MiddleName: | FAIZ | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 98820 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891938820 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7024078241 | ||||||||
| FaxNumber: | 7024921728 | ||||||||
| Practice Location | |||||||||
| Address1: | 10410 S EASTERN AVE | ||||||||
| Address2: | SUITE #100 | ||||||||
| City: | HENDERSON | ||||||||
| State: | NV | ||||||||
| PostalCode: | 890524195 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7029147150 | ||||||||
| FaxNumber: | 7029141924 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2006 | ||||||||
| LastUpdateDate: | 08/18/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 10030 | NV | N | Other Service Providers | Specialist | 207RG0300X | 10030 | NV | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine | 207QA0505X | 10030 | NV | N | Allopathic & Osteopathic Physicians | Family Medicine | Adult Medicine |
ID Information
| ID | Type | State | Issuer | Description | 002018700 | 05 | NV | MEDICAID | 110241360 | 01 | RAILROAD CARRIER | OTHER |