Provider Demographics
NPI:1063594372
Name:ANSARI, RASHAD (MD)
Entity type:Individual
Prefix:
First Name:RASHAD
Middle Name:
Last Name:ANSARI
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 1:2023 W VISTA WAY
Mailing Address - Street 2:STE. J
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92083-6030
Mailing Address - Country:US
Mailing Address - Phone:760-724-6100
Mailing Address - Fax:
Practice Address - Street 1:2023 W VISTA WAY
Practice Address - Street 2:STE. J
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083-6030
Practice Address - Country:US
Practice Address - Phone:760-724-6100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG52073207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA110009177OtherMEDICARE RAILROAD
CA110009177OtherMEDICARE RAILROAD
CA0232620001Medicare NSC
CAG52073Medicare PIN