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General NPI Number Information
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NPI Number | 1801854450
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Entity Type | Individual
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Provider Name | TAREK I. HASSANEIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 131 ORANGE AVE STE 101
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City | CORONADO
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State | CA
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Zip | 92118-1408
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Country | US
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Telephone | 619-522-0399
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 181770
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City | CORONADO
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State | CA
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Zip | 92178-1770
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Country | US
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Telephone | 619-964-9649
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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 | 207RI0008X
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Taxonomy Name | Hepatology Physician
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License Number | A54452
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | A54452
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License Number State | CA
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