Individual
DR. FAZAL-UR-RAHMAN MIRZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
17707 STUDEBAKER RD, CERRITOS, CA 90703-2640
(562) 402-0688
(562) 402-3032
Mailing address
6042 MARILYN DR, CYPRESS, CA 90630-3944
(714) 826-0505
(562) 402-3032
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A32119
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A32119
PHYSICIAN LICENSE
CA
01
—
WA32119A
PPIN
CA
Enumeration date
10/11/2006
Last updated
03/07/2023
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