Healthcare Provider Details

I. General information

NPI: 1154095289
Provider Name (Legal Business Name): HASSEN HASSEN PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2021
Last Update Date: 08/03/2021
Certification Date: 07/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 W ALLUVIAL AVE STE 101
FRESNO CA
93711-5509
US

IV. Provider business mailing address

4530 S NORMANDIE AVE APT 205
LOS ANGELES CA
90037-2878
US

V. Phone/Fax

Practice location:
  • Phone: 323-630-3250
  • Fax: 559-432-2349
Mailing address:
  • Phone: 323-376-9432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number83911
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: