Provider Demographics
NPI:1346996410
Name:ISMAEL, HASSAN SAAD
Entity Type:Individual
Prefix:
First Name:HASSAN
Middle Name:SAAD
Last Name:ISMAEL
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 1:9804 TUSCARORA DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-2442
Mailing Address - Country:US
Mailing Address - Phone:951-463-7071
Mailing Address - Fax:
Practice Address - Street 1:317 E KINGS ST
Practice Address - Street 2:
Practice Address - City:AVENAL
Practice Address - State:CA
Practice Address - Zip Code:93204-1630
Practice Address - Country:US
Practice Address - Phone:559-345-6737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-26
Last Update Date:2022-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH85447183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist