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Individual
FHARAK MAA CHIP
Active
Individual
FHARAK MAA CHIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
A117604
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A117604
CA LICENSE
CA
01
—
CA124198
NO. CALIFORNIA PTAN
CA
01
—
CB216371
SO. CALIFORNIA PTAN
CA
Enumeration date
07/21/2011
Last updated
01/26/2021
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