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General NPI Number Information
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NPI Number | 1588826242
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Entity Type | Individual
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Provider Name | MRS. MANDANA ABOLLHASSANI
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Gender | Female
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Dates
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Enumeration Date | 06/25/2008
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Last Update Date | 10/26/2017
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Provider Practice Location Address
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Address Line | 1900 SULLIVAN AVE
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City | DALY CITY
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State | CA
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Zip | 94015-2200
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Country | US
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Telephone | 650-991-5800
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Fax | 650-991-6385
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Provider Business Mailing Address
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Address Line | 312 CANOE CURT
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City | REDWOOD CITY
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State | CA
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Zip | 94065-0004
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Country | US
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Telephone | 650-722-3041
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | A115564
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A115564
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | A115564
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License Number State | CA
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