Provider Demographics
NPI:1558474437
Name:S.HASNAT AHMED, MD, APC
Entity Type:Organization
Organization Name:S.HASNAT AHMED, MD, APC
Other - Org Name:ONCOLOGY AND HEMATOLOGY OF IMPERIAL VALLEY, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHROSTOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-292-4022
Mailing Address - Street 1:PO BOX 23058
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92193-3058
Mailing Address - Country:US
Mailing Address - Phone:858-292-4022
Mailing Address - Fax:858-292-1898
Practice Address - Street 1:1410 S LA BRUCHERIE RD
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-9676
Practice Address - Country:US
Practice Address - Phone:760-335-3030
Practice Address - Fax:760-335-3035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA54334207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ64379ZOtherBLUE SHIELD GROUP #
CA00A543340Medicaid
CAP00228825OtherRR MEDICARE PIN #
CADD4504OtherRR MEDICARE GROUP #
CAGR0099820Medicaid
CAW18370Medicare ID - Type UnspecifiedMCARE GROUP NUMBER
CAWA54334BMedicare ID - Type UnspecifiedMCARE PERFORMING PROVIDER
CAGR0099820Medicaid