Provider Demographics
NPI:1457856379
Name:HASSAN, ABD-ELRAHMAN SAID
Entity Type:Individual
Prefix:
First Name:ABD-ELRAHMAN
Middle Name:SAID
Last Name:HASSAN
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 1:127 DREAM ST
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-6765
Mailing Address - Country:US
Mailing Address - Phone:707-386-9889
Mailing Address - Fax:
Practice Address - Street 1:127 DREAM ST
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-6765
Practice Address - Country:US
Practice Address - Phone:707-386-9889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-25
Last Update Date:2018-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program