Provider Demographics
NPI:1396242186
Name:KUBLAN, ABDUL RAHMAN (MD)
Entity type:Individual
Prefix:
First Name:ABDUL
Middle Name:RAHMAN
Last Name:KUBLAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 W LA VERNE AVE STE D
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-2347
Mailing Address - Country:US
Mailing Address - Phone:909-464-0009
Mailing Address - Fax:909-464-0010
Practice Address - Street 1:175 W LA VERNE AVE STE D
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-2347
Practice Address - Country:US
Practice Address - Phone:909-464-0009
Practice Address - Fax:909-464-0010
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA173426207V00000X, 207Q00000X
VA0101276678207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine