Healthcare Provider Details

I. General information

NPI: 1417179318
Provider Name (Legal Business Name): AMINA HASSAN-ELSAYED M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 11/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26700 TOWNE CENTRE DR STE 150
FOOTHILL RANCH CA
92610-2844
US

IV. Provider business mailing address

26700 TOWNE CENTRE DR STE 150
FOOTHILL RANCH CA
92610-2844
US

V. Phone/Fax

Practice location:
  • Phone: 949-837-7337
  • Fax: 949-837-7347
Mailing address:
  • Phone: 949-837-7337
  • Fax: 949-837-7347

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA94330
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: