Provider Demographics
NPI:1487929972
Name:BALOGUN, RAHMAT (DO)
Entity type:Individual
Prefix:DR
First Name:RAHMAT
Middle Name:
Last Name:BALOGUN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2330 POST STREET
Mailing Address - Street 2:SUITE 460
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:49115
Mailing Address - Country:US
Mailing Address - Phone:415-221-4810
Mailing Address - Fax:
Practice Address - Street 1:2330 POST STREET
Practice Address - Street 2:SUITE 460
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:49115
Practice Address - Country:US
Practice Address - Phone:415-221-4810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-15
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY271433207R00000X
CA140372083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine