Provider Demographics
NPI:1619341500
Name:AISSATOU HAMAN MD INC
Entity Type:Organization
Organization Name:AISSATOU HAMAN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AISSATOU
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-867-3054
Mailing Address - Street 1:9030 BRENTWOOD BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-4095
Mailing Address - Country:US
Mailing Address - Phone:925-634-9704
Mailing Address - Fax:925-243-7551
Practice Address - Street 1:1 SHRADER ST
Practice Address - Street 2:SUITE 570
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-1016
Practice Address - Country:US
Practice Address - Phone:415-867-3054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-16
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA115745207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty