Provider Demographics
NPI:1154095289
Name:HASSEN, HASSEN (PHARMD)
Entity Type:Individual
Prefix:
First Name:HASSEN
Middle Name:
Last Name:HASSEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4530 S NORMANDIE AVE APT 205
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90037-2878
Mailing Address - Country:US
Mailing Address - Phone:323-376-9432
Mailing Address - Fax:
Practice Address - Street 1:740 W ALLUVIAL AVE STE 101
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-5509
Practice Address - Country:US
Practice Address - Phone:323-630-3250
Practice Address - Fax:559-432-2349
Is Sole Proprietor?:No
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83911183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist