Provider Demographics
NPI:1164017174
Name:ADDE, HASHIM SUFI
Entity Type:Individual
Prefix:MR
First Name:HASHIM
Middle Name:SUFI
Last Name:ADDE
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:PO BOX 663
Mailing Address - Street 2:
Mailing Address - City:LEMON GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:91946-0663
Mailing Address - Country:US
Mailing Address - Phone:619-730-5025
Mailing Address - Fax:
Practice Address - Street 1:5040 KEENEY ST APT 40
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-7459
Practice Address - Country:US
Practice Address - Phone:619-730-5025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)