Provider Demographics
NPI:1255524427
Name:HASHISHO, MAZEN (MD)
Entity type:Individual
Prefix:DR
First Name:MAZEN
Middle Name:
Last Name:HASHISHO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5150 E PACIFIC COAST HWY STE 500
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-3328
Mailing Address - Country:US
Mailing Address - Phone:562-299-5200
Mailing Address - Fax:562-299-5294
Practice Address - Street 1:12555 GARDEN GROVE BLVD STE 403
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-1903
Practice Address - Country:US
Practice Address - Phone:562-506-0176
Practice Address - Fax:562-506-0053
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA943292086S0129X, 208G00000X
PAMD4412652086S0129X
NY0028452086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)