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NPI Code Detail

MEDICARE: HAEWON ASFAW

MEDICARE: HAEWON ASFAW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1093207581
Entity Type Code : Individual
Provider Name (Legal Business Name) : HAEWON ASFAW
Provider Business Mailing Address
First Line : PO BOX 22210
Second Line :
City : OAKLAND
State : CA
Zip : 94623-2210
Country : US
Telephone Number : 510-535-6200
Fax Number :
Provider Business Practice Location Address
First Line : 1926 E 19TH ST
Second Line :
City : OAKLAND
State : CA
Zip : 94606-4126
Country : US
Telephone Number : 510-535-2893
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2018
Last Update Date : 05/31/2018

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Directions to “ HAEWON ASFAW ” Practice Location

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