Healthcare Provider Details

I. General information

NPI: 1104171925
Provider Name (Legal Business Name): HASSAN JADID M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2012
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

481 N WHEATGRASS DR
ORANGE CA
92869-6025
US

IV. Provider business mailing address

481 N WHEATGRASS DR
ORANGE CA
92869-6025
US

V. Phone/Fax

Practice location:
  • Phone: 909-289-1070
  • Fax:
Mailing address:
  • Phone: 909-289-1060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA144275
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME129422
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: