Provider Demographics
NPI:1407611049
Name:DENTISTS OF CHULA VISTA HAZZAA YAHYA GEN PTR
Entity type:Organization
Organization Name:DENTISTS OF CHULA VISTA HAZZAA YAHYA GEN PTR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HAZZAA
Authorized Official - Middle Name:
Authorized Official - Last Name:YAHYA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:713-480-8607
Mailing Address - Street 1:664 PALOMAR ST STE 1103
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-2611
Mailing Address - Country:US
Mailing Address - Phone:619-429-3948
Mailing Address - Fax:
Practice Address - Street 1:664 PALOMAR ST STE 1103
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-2611
Practice Address - Country:US
Practice Address - Phone:619-429-3948
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-13
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental