Provider Demographics
NPI:1790954378
Name:TAOHEED HASAN
Entity Type:Organization
Organization Name:TAOHEED HASAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PIC/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TAOHEED
Authorized Official - Middle Name:
Authorized Official - Last Name:HASAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-942-8777
Mailing Address - Street 1:1324 W AVENUE J STE 1
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-2948
Mailing Address - Country:US
Mailing Address - Phone:661-942-8777
Mailing Address - Fax:661-942-8795
Practice Address - Street 1:1324 W AVENUE J STE 1
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2948
Practice Address - Country:US
Practice Address - Phone:661-942-8777
Practice Address - Fax:661-942-8795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHA4686603336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5348900001Medicare NSC