Provider Demographics
NPI:1851547061
Name:HASEEB AL-MUFTI, M.D., INC.
Entity Type:Organization
Organization Name:HASEEB AL-MUFTI, M.D., INC.
Other - Org Name:RENAL ASSOCIATES, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HASEEB
Authorized Official - Middle Name:I
Authorized Official - Last Name:AL-MUFTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-604-6012
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:510-483-2480
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:510-483-2480
Practice Address - Fax:415-974-0670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-07
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA37195174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty