Provider Demographics
NPI:1467154666
Name:HUMAYUN, HINA
Entity Type:Individual
Prefix:
First Name:HINA
Middle Name:
Last Name:HUMAYUN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1018 S WEDGEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94582-5726
Mailing Address - Country:US
Mailing Address - Phone:925-406-9537
Mailing Address - Fax:
Practice Address - Street 1:1301 S 7TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85007-3957
Practice Address - Country:US
Practice Address - Phone:615-665-6318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program