Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 59478 | CA |
NPI | 1114231610 |
---|---|
Provider Name | Dr. Nadia Hassan |
First Address | Diamond Bar, CA 91765-3608 |
Second Address | Diamond Bar, CA 91765-3608 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2010 |
Last Update Date | 27/07/2010 |