Provider Demographics
NPI:1427122928
Name:HASSLER, SHAWN KENT (MD)
Entity type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:KENT
Last Name:HASSLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:870 MARKET ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-3002
Mailing Address - Country:US
Mailing Address - Phone:415-397-0700
Mailing Address - Fax:415-397-6805
Practice Address - Street 1:870 MARKET ST
Practice Address - Street 2:SUITE 600
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-3002
Practice Address - Country:US
Practice Address - Phone:415-397-0700
Practice Address - Fax:415-397-6802
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA062683207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA062683OtherMEDICAL LICENSE NUMBER
CACNC324854Medicaid
CAG77471Medicare UPIN
CACNC324854Medicaid