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General NPI Number Information
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NPI Number | 1386323038
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Entity Type | Organization
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Legal Business Name | HARRISON HASANUDDIN, D.O., INC.
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Dates
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Enumeration Date | 07/11/2023
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Last Update Date | 06/22/2025
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Provider Practice Location Address
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Address Line | 420 N GARFIELD AVE STE 203
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City | MONTEREY PARK
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State | CA
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Zip | 91754-1206
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Country | US
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Telephone | 626-763-1899
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Fax | 626-547-4438
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Provider Business Mailing Address
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Address Line | 420 N GARFIELD AVE STE 203
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City | MONTEREY PARK
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State | CA
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Zip | 91754-1206
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Country | US
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Telephone | 626-763-1899
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Fax | 626-547-4438
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Authorized Official
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Title or Position | PRESIDENT
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Name | HARRISON HASANUDDIN
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Credential | DO
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Telephone | 626-763-1899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207QB0002X
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Taxonomy Name | Obesity Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207QS1201X
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Taxonomy Name | Sleep Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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