Healthcare Provider Details

I. General information

NPI: 1912954934
Provider Name (Legal Business Name): SYED TANWEER HAKIM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 10/11/2025
Certification Date: 10/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5763 STEVENSON BLVD
NEWARK CA
94560-5301
US

IV. Provider business mailing address

5763 STEVENSON BLVD
NEWARK CA
94560-5301
US

V. Phone/Fax

Practice location:
  • Phone: 510-656-5700
  • Fax:
Mailing address:
  • Phone: 510-656-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberC168590
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: