Provider Demographics
NPI:1205624145
Name:WAHEED, HASSAN (MD)
Entity type:Individual
Prefix:DR
First Name:HASSAN
Middle Name:
Last Name:WAHEED
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 W 7TH ST APT 402
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-7313
Mailing Address - Country:US
Mailing Address - Phone:832-586-4291
Mailing Address - Fax:
Practice Address - Street 1:4816 E 3RD ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90022-1602
Practice Address - Country:US
Practice Address - Phone:323-953-7330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1740835743390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program