Healthcare Provider Details

I. General information

NPI: 1316867971
Provider Name (Legal Business Name): HASHEM AWNALLAH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 SAN LEANDRO BLVD UNIT 312
SAN LEANDRO CA
94577-1533
US

IV. Provider business mailing address

101 CALLAN AVE STE 220
SAN LEANDRO CA
94577-4558
US

V. Phone/Fax

Practice location:
  • Phone: 510-359-4164
  • Fax:
Mailing address:
  • Phone: 510-359-4164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: