MEDICARE: DR. ENAS RASHID YASSIN MD,BSN, NP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	NP95027385	CA
2	363LG0600X	Gerontology Nurse Practitioner	NP95027385	CA
3	363L00000X	Nurse Practitioner	NP95027385	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NP95027385	OTHER	CA	LICENSE

General Provider Information

NPI Number	:	1245597640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ENAS RASHID YASSIN MD,BSN, NP-C

Provider Business Mailing Address
First Line	:	1850 EL CAMINO REAL STE 200
Second Line	:
City	:	BURLINGAME
State	:	CA
Zip	:	94010-3102
Country	:	US
Telephone Number	:	650-697-2431
Fax Number	:	650-697-3659

Provider Business Practice Location Address
First Line	:	1850 EL CAMINO REAL STE 200
Second Line	:
City	:	BURLINGAME
State	:	CA
Zip	:	94010-3102
Country	:	US
Telephone Number	:	650-697-2431
Fax Number	:	650-697-3659

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2012
Last Update Date	:	07/25/2024

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