| Harrison Hasanuddin, D.o., Inc. | |
|
1336 W Valley Blvd Ste A Alhambra CA 91803-2480 | |
| (626) 215-5335 | |
| Not Available |
| Full Name | Harrison Hasanuddin, D.o., Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 1336 W Valley Blvd Ste A, Alhambra, California |
| Authorized Official Name and Position | Harrison Hasanuddin (PRESIDENT) |
| Authorized Official Contact | 6262155335 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Harrison Hasanuddin, D.o., Inc. 88 S Garfield Ave Unit 128 Alhambra CA 91801-6891 Ph: (626) 215-5335 | Harrison Hasanuddin, D.o., Inc. 1336 W Valley Blvd Ste A Alhambra CA 91803-2480 Ph: (626) 215-5335 |
| NPI Number | 1386323038 |
|---|---|
| Provider Enumeration Date | 07/11/2023 |
| Last Update Date | 07/11/2023 |
| Medicare PECOS PAC ID | 9032571336 |
|---|---|
| Medicare Enrollment ID | O20230818000712 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386323038 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207QS1201X | Family Medicine - Sleep Medicine | (* (Not Available)) | Primary |
| Provider Name | Harrison Hasanuddin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790165785 PECOS PAC ID: 8729376405 Enrollment ID: I20190102002289 |
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