Provider Demographics
NPI:1548495781
Name:RAHMAN, KRAIG MAHBUB (PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:KRAIG
Middle Name:MAHBUB
Last Name:RAHMAN
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6840 EAGLE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:GILROY
Mailing Address - State:CA
Mailing Address - Zip Code:95020-3032
Mailing Address - Country:US
Mailing Address - Phone:408-842-6395
Mailing Address - Fax:408-842-6395
Practice Address - Street 1:880 NORTHRIDGE CTR
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906-2007
Practice Address - Country:US
Practice Address - Phone:831-449-2481
Practice Address - Fax:831-449-0934
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-18
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH50001183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist