Healthcare Provider Details
I. General information
NPI: 1710752464
Provider Name (Legal Business Name): HEALTH SEED LA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/21/2023
Last Update Date: 11/21/2023
Certification Date: 11/21/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2637 E WASHINGTON BLVD
PASADENA CA
91107-1412
US
IV. Provider business mailing address
832 W 29TH ST APT B
SAN PEDRO CA
90731-6236
US
V. Phone/Fax
- Phone: 626-798-8991
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HASAN
SEEDE
Title or Position: OWNER
Credential: MD
Phone: 626-616-0420