Healthcare Provider Details

I. General information

NPI: 1972391001
Provider Name (Legal Business Name): MOUSTAFA EL-HASSAN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2025
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9100 WILSHIRE BLVD STE 840W
BEVERLY HILLS CA
90212-3556
US

IV. Provider business mailing address

138 N CLARK DR APT A
BEVERLY HILLS CA
90211-4718
US

V. Phone/Fax

Practice location:
  • Phone: 424-777-0708
  • Fax:
Mailing address:
  • Phone: 612-735-5548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number84276
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: