Provider Demographics
NPI:1174629950
Name:HADAYA, BASSEL (MD)
Entity Type:Individual
Prefix:DR
First Name:BASSEL
Middle Name:
Last Name:HADAYA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 2768
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93539-2768
Mailing Address - Country:US
Mailing Address - Phone:661-948-1388
Mailing Address - Fax:661-948-1223
Practice Address - Street 1:1759 W AVENUE J
Practice Address - Street 2:STE 101
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2703
Practice Address - Country:US
Practice Address - Phone:661-948-1388
Practice Address - Fax:661-948-1223
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CABH7935971207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA79960BMedicare PIN
CAI44650Medicare UPIN