Organization Name: | HASSAN A KOBAISSI DPM |
NPI Number: | 1245632777 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | HASSAN A KOBAISSI (CEO) |
Mailing Address: | 3180 Colima Rd Suite A Hacienda Heights |
State: | CA US |
Postal Code: | 917456315 |
Phone Number: | 6269611882 |
Fax Number: | 6269687599 |
NPI Enumeration Date: | 09/16/2014 |
NPI Last Update Date: | 03/25/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | E4235 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |