Provider Demographics
NPI:1578178661
Name:JASIM, FIRAS
Entity Type:Individual
Prefix:
First Name:FIRAS
Middle Name:
Last Name:JASIM
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 1:494 EL MONTE RD
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-3024
Mailing Address - Country:US
Mailing Address - Phone:619-456-7893
Mailing Address - Fax:
Practice Address - Street 1:833 BROADWAY # 201-H
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-4668
Practice Address - Country:US
Practice Address - Phone:619-464-9645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-15
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker