# SHAHLA P RAHMATULLAH M.D. INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922296854
- **Authorized official:** MS. SHAHLA P RAHMATULLAH MD (PROVIDER)
- **Authorized official phone:** (949) 653-1300

## Contact information

- **Practice address:** 4870 BARRANCA PKWY STE 230, IRVINE, CA 92604-4788
- **Practice address phone:** (949) 653-1300
- **Practice address fax:** (949) 653-1311
- **Mailing address:** 351 OLD NEWPORT BLVD, SUITE 212, NEWPORT BEACH, CA 92663-4120
- **Mailing address phone:** (949) 653-1300
- **Mailing address fax:** (949) 353-1311

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 00C519930 | CA | Yes |

## Other

- **Enumeration date:** 10/04/2007
- **Last updated:** 12/16/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00C519930 | — | CA |