Provider Demographics
NPI:1649223017
Name:AL-MUFTI, HASEEB IBRAHIM (MD)
Entity Type:Individual
Prefix:DR
First Name:HASEEB
Middle Name:IBRAHIM
Last Name:AL-MUFTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:660 4TH ST
Mailing Address - Street 2:UNIT 349
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-1618
Mailing Address - Country:US
Mailing Address - Phone:510-604-6012
Mailing Address - Fax:415-974-0670
Practice Address - Street 1:13939 E 14TH ST
Practice Address - Street 2:SUITE 170
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-2613
Practice Address - Country:US
Practice Address - Phone:510-604-6012
Practice Address - Fax:415-974-0670
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA37195207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA37195OtherMEDICAL LICENSE NUMBER