Provider Demographics
NPI:1407897093
Name:HASEEB, ABDUL MUSTAJEEB (MD)
Entity Type:Individual
Prefix:DR
First Name:ABDUL
Middle Name:MUSTAJEEB
Last Name:HASEEB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ABDUL
Other - Middle Name:MUSTAJEEB
Other - Last Name:HASEEB
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 25100
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93729-5100
Mailing Address - Country:US
Mailing Address - Phone:559-326-1222
Mailing Address - Fax:559-326-1230
Practice Address - Street 1:7130 N MILLBROOK AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3347
Practice Address - Country:US
Practice Address - Phone:559-326-1222
Practice Address - Fax:559-326-1230
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA76480207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA760241OtherMEDICAL LICENSE
CAP00242086OtherRAILROAD MEDICARE
CAZZZ37565ZOtherMEDICARE ID
CAA760241OtherMEDICAL LICENSE