Provider Demographics
NPI:1215499256
Name:HASAN, ASBAT (MD)
Entity type:Individual
Prefix:DR
First Name:ASBAT
Middle Name:
Last Name:HASAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MOHAMMAD
Other - Middle Name:ASBAT
Other - Last Name:HASAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3956 LAVINE WAY UNIT 110
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92883-3651
Mailing Address - Country:US
Mailing Address - Phone:951-315-2174
Mailing Address - Fax:
Practice Address - Street 1:6180 BROCKTON AVE STE 204
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-2233
Practice Address - Country:US
Practice Address - Phone:951-781-7700
Practice Address - Fax:851-781-0313
Is Sole Proprietor?:No
Enumeration Date:2019-04-01
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA178990207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology