Provider Demographics
NPI:1538202155
Name:RAH, ANDREW D (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:D
Last Name:RAH
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 1:7301 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-1904
Mailing Address - Country:US
Mailing Address - Phone:818-264-3344
Mailing Address - Fax:818-264-3433
Practice Address - Street 1:7301 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 400
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-1904
Practice Address - Country:US
Practice Address - Phone:818-264-3344
Practice Address - Fax:818-264-3433
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG82333173000000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG79545Medicare UPIN