Individual
DR. ABUL ALA SYED RIFAT MANNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 DUARTE RD, DUARTE, CA 91010-3012
(626) 256-4673
Mailing address
PO BOX 512185, LOS ANGELES, CA 90051-0185
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
MD460931
PA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
A168641
CA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MD460931
PA
Other
Enumeration date
07/12/2013
Last updated
01/12/2021
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