Provider Demographics
NPI:1437652278
Name:ERGIN, HASAN SUHA (MD)
Entity Type:Individual
Prefix:
First Name:HASAN
Middle Name:SUHA
Last Name:ERGIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3925 SKYLINE RD
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-2746
Mailing Address - Country:US
Mailing Address - Phone:760-803-8090
Mailing Address - Fax:
Practice Address - Street 1:3925 SKYLINE RD
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-2746
Practice Address - Country:US
Practice Address - Phone:760-803-8090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-16
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG33378207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty