Provider Demographics
NPI:1659976801
Name:HASAN SYED MD INC
Entity Type:Organization
Organization Name:HASAN SYED MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LENELL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-315-6515
Mailing Address - Street 1:5450 JEFFERSON AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-3522
Mailing Address - Country:US
Mailing Address - Phone:909-315-6515
Mailing Address - Fax:909-315-6525
Practice Address - Street 1:5450 JEFFERSON AVE STE 2
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91710-3522
Practice Address - Country:US
Practice Address - Phone:909-315-6515
Practice Address - Fax:909-315-6525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-03
Last Update Date:2024-03-26
Deactivation Date:2024-02-23
Deactivation Code:
Reactivation Date:2024-03-26
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty