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General NPI Number Information
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NPI Number | 1265692628
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Entity Type | Individual
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Provider Name | HASSAN J. AFSHAR
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Gender | Male
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Dates
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Enumeration Date | 06/10/2008
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Last Update Date | 06/10/2008
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Provider Practice Location Address
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Address Line | 22471 ASPAN ST SUITE 103
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City | LAKE FOREST
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State | CA
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Zip | 92630-1642
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Country | US
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Telephone | 949-458-2715
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Fax | 949-458-3583
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Provider Business Mailing Address
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Address Line | PO BOX 11053
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City | NEWPORT BEACH
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State | CA
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Zip | 92658-5017
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Country | US
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Telephone | 949-642-3248
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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