Provider Demographics
NPI:1952343915
Name:HASAN, SOBIA (DO)
Entity Type:Individual
Prefix:
First Name:SOBIA
Middle Name:
Last Name:HASAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1294 W 6TH ST
Mailing Address - Street 2:STE 103
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90731-2987
Mailing Address - Country:US
Mailing Address - Phone:310-831-9482
Mailing Address - Fax:310-831-1230
Practice Address - Street 1:1294 W 6TH ST
Practice Address - Street 2:STE 103
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90731-2987
Practice Address - Country:US
Practice Address - Phone:310-831-9482
Practice Address - Fax:310-831-1230
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2013-11-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA20A9034207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine