Provider Demographics
NPI:1932183829
Name:AL HASAN, MOHAMMAD SAID (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:SAID
Last Name:AL HASAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MOHAMMAD
Other - Middle Name:SAID
Other - Last Name:AL-HASAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:41 SANTA ANA RD
Mailing Address - Street 2:
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-4016
Mailing Address - Country:US
Mailing Address - Phone:831-638-0212
Mailing Address - Fax:831-638-0214
Practice Address - Street 1:41 SANTA ANA RD
Practice Address - Street 2:
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-4016
Practice Address - Country:US
Practice Address - Phone:831-638-0212
Practice Address - Fax:831-638-0214
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-03
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA61093207P00000X, 207RN0300X
NY306759-01207P00000X, 207R00000X
CAA061093207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A610930Medicaid
CA00A610930OtherMEDI CAL
CAOTM042OtherHMO #
CAOTM042OtherHMO #
CA00A610930OtherMEDI CAL
CA00A610933Medicare PIN