Healthcare Provider Details

I. General information

NPI: 1396432456
Provider Name (Legal Business Name): HESHAM HALTEH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2023
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

88 EDGEMONT DR
DALY CITY CA
94015-3808
US

IV. Provider business mailing address

88 EDGEMONT DR
DALY CITY CA
94015-3808
US

V. Phone/Fax

Practice location:
  • Phone: 415-343-5817
  • Fax: 855-264-7861
Mailing address:
  • Phone: 415-343-5817
  • Fax: 855-264-7861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246W00000X
TaxonomyCardiology Technician
License Number00118104
License Number State
# 2
Primary TaxonomyN
Taxonomy Code246XS1301X
TaxonomySonography Specialist/Technologist Cardiovascular
License Number136434
License Number State
# 3
Primary TaxonomyY
Taxonomy Code246X00000X
TaxonomyCardiovascular Specialist/Technologist
License Number136434
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: