Provider Demographics
NPI:1942783097
Name:HASHIM, ALI N
Entity Type:Individual
Prefix:
First Name:ALI
Middle Name:N
Last Name:HASHIM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6919 PARADISE VALLEY RD STE 2
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92139-1225
Mailing Address - Country:US
Mailing Address - Phone:619-490-5059
Mailing Address - Fax:
Practice Address - Street 1:6919 PARADISE VALLEY RD STE 2
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92139-1225
Practice Address - Country:US
Practice Address - Phone:619-490-5059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-13
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1447761283Medicaid