Provider Demographics
NPI:1649705807
Name:HASSANIN, MOHAMED (DC)
Entity type:Individual
Prefix:
First Name:MOHAMED
Middle Name:
Last Name:HASSANIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:MOHAMED
Other - Middle Name:
Other - Last Name:HASSANIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:18377 BEACH BLVD STE 108
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-1349
Mailing Address - Country:US
Mailing Address - Phone:714-676-8870
Mailing Address - Fax:714-676-8871
Practice Address - Street 1:18377 BEACH BLVD STE 108
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-1349
Practice Address - Country:US
Practice Address - Phone:714-676-8870
Practice Address - Fax:714-676-8871
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-25
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33844111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor