Provider Demographics
NPI:1114010527
Name:HASAN, TAOHEED (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:TAOHEED
Middle Name:
Last Name:HASAN
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1324 WEST AVE J
Mailing Address - Street 2:SUITE 7
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534
Mailing Address - Country:US
Mailing Address - Phone:661-942-8777
Mailing Address - Fax:661-942-8795
Practice Address - Street 1:1324 WEST AVE J
Practice Address - Street 2:SUITE 1
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534
Practice Address - Country:US
Practice Address - Phone:661-942-8777
Practice Address - Fax:661-942-8795
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-30
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH38785183500000X
CAPHY468660333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5614246OtherNABP
CAPHA468660Medicaid