Provider Demographics
NPI:1124463989
Name:KANJI, REHAN AMIN (MD)
Entity type:Individual
Prefix:
First Name:REHAN
Middle Name:AMIN
Last Name:KANJI
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 1:12126 SARDIS AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-3524
Mailing Address - Country:US
Mailing Address - Phone:310-562-5625
Mailing Address - Fax:877-549-0514
Practice Address - Street 1:12126 SARDIS AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-3524
Practice Address - Country:US
Practice Address - Phone:310-562-5625
Practice Address - Fax:877-549-0514
Is Sole Proprietor?:No
Enumeration Date:2013-05-07
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA137961207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine