Provider Demographics
NPI:1912954934
Name:HAKIM, SYED TANWEER (MD)
Entity type:Individual
Prefix:DR
First Name:SYED
Middle Name:TANWEER
Last Name:HAKIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5763 STEVENSON BLVD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:CA
Mailing Address - Zip Code:94560-5301
Mailing Address - Country:US
Mailing Address - Phone:510-656-5700
Mailing Address - Fax:
Practice Address - Street 1:5763 STEVENSON BLVD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:CA
Practice Address - Zip Code:94560-5301
Practice Address - Country:US
Practice Address - Phone:510-656-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC168590208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200459290Medicaid
IN193310TTMedicare ID - Type Unspecified