Provider Demographics
NPI:1417179318
Name:HASSAN-ELSAYED, AMINA (MD)
Entity Type:Individual
Prefix:DR
First Name:AMINA
Middle Name:
Last Name:HASSAN-ELSAYED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26700 TOWNE CENTRE DR
Mailing Address - Street 2:STE 150
Mailing Address - City:FOOTHILL RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92610-2844
Mailing Address - Country:US
Mailing Address - Phone:949-837-7337
Mailing Address - Fax:949-837-7347
Practice Address - Street 1:26700 TOWNE CENTRE DR
Practice Address - Street 2:STE 150
Practice Address - City:FOOTHILL RANCH
Practice Address - State:CA
Practice Address - Zip Code:92610-2844
Practice Address - Country:US
Practice Address - Phone:949-837-7337
Practice Address - Fax:949-837-7347
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94330208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA94330OtherMEDICAL LIC
CA1912265257Medicaid
CAGB097AMedicare PIN
CAGB093ZMedicare PIN