MEDICARE: DR. HAZEM M. HASHEM M.D.

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
1	2084P0800X	Psychiatry Physician	A48858	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902882574
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HAZEM M. HASHEM M.D.

Provider Business Mailing Address
First Line	:	220 BRIGHTON CIR
Second Line	:
City	:	VACAVILLE
State	:	CA
Zip	:	95687-8204
Country	:	US
Telephone Number	:	707-249-2025
Fax Number	:

Provider Business Practice Location Address
First Line	:	4441 E KINGS CANYON RD
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93702-3604
Country	:	US
Telephone Number	:	559-600-9813
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2005
Last Update Date	:	11/01/2021

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