Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | C134457 | CA |
Y | 2080P0205X | Pediatric Endocrinologist | C134457 | CA |
NPI | 1417919085 |
---|---|
Provider Name | Khalid S Hasan |
First Address | Newhall, CA 91321-2558 |
Second Address | Newhall, CA 91321 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2006 |
Last Update Date | 02/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
147208 | (05) | AZ |
F79584 | (02) |