Provider Demographics
NPI:1154854206
Name:HASASSRI, METHUS EARTH (MD)
Entity Type:Individual
Prefix:DR
First Name:METHUS
Middle Name:EARTH
Last Name:HASASSRI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:EARTH
Other - Middle Name:
Other - Last Name:HASASSRI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:825 OAK GROVE AVE STE D202
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-4427
Mailing Address - Country:US
Mailing Address - Phone:650-468-0572
Mailing Address - Fax:641-200-6359
Practice Address - Street 1:825 OAK GROVE AVE STE D202
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-4427
Practice Address - Country:US
Practice Address - Phone:650-468-0572
Practice Address - Fax:641-200-6359
Is Sole Proprietor?:No
Enumeration Date:2017-04-05
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1577002084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry