Provider Demographics
NPI:1033179379
Name:HASHEM, HANI H (MD)
Entity Type:Individual
Prefix:
First Name:HANI
Middle Name:H
Last Name:HASHEM
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 1:546 W BADILLO ST STE D
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91722-3762
Mailing Address - Country:US
Mailing Address - Phone:626-331-2222
Mailing Address - Fax:626-331-2233
Practice Address - Street 1:546 W BADILLO ST STE D
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91722-3786
Practice Address - Country:US
Practice Address - Phone:626-331-2222
Practice Address - Fax:625-331-2233
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA79405207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH26877Medicare UPIN