Provider Demographics
NPI:1013013218
Name:RASSAI, HAMID R
Entity Type:Individual
Prefix:
First Name:HAMID
Middle Name:R
Last Name:RASSAI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:365 LENNON LN STE 250
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-5915
Mailing Address - Country:US
Mailing Address - Phone:925-627-3494
Mailing Address - Fax:925-627-1592
Practice Address - Street 1:3903 LONE TREE WAY
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-6249
Practice Address - Country:US
Practice Address - Phone:925-757-0800
Practice Address - Fax:925-757-2160
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA060998208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A609980Medicare PIN
CAH13834Medicare UPIN
CA00A609981Medicare PIN