Basic Information
| Provider Information | |||||||||
| NPI: | 1518276880 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ABDULRAHMAN | ||||||||
| FirstName: | DIANA | ||||||||
| MiddleName: | MOHINE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2895 N TOWNE AVE | ||||||||
| Address2: | |||||||||
| City: | POMONA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917672009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9099822719 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2895 N TOWNE AVE | ||||||||
| Address2: | |||||||||
| City: | POMONA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917672009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9099822719 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2010 | ||||||||
| LastUpdateDate: | 04/08/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 04/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1744R1102X | N | Other Service Providers | Specialist | Research Study | 2084V0102X | A139768 | CA | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Vascular Neurology | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 2084N0400X | 51601 | AZ | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
No ID Information.