Provider Demographics
NPI:1053013748
Name:ABDELHAK, AHMED MOHAMED TAHA (MB CHB)
Entity type:Individual
Prefix:
First Name:AHMED
Middle Name:MOHAMED TAHA
Last Name:ABDELHAK
Suffix:
Gender:M
Credentials:MB CHB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1651 4TH ST STE 252
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94158-2324
Mailing Address - Country:US
Mailing Address - Phone:415-353-2069
Mailing Address - Fax:415-353-2633
Practice Address - Street 1:1651 4TH ST STE 252
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94158-2324
Practice Address - Country:US
Practice Address - Phone:415-353-2069
Practice Address - Fax:415-353-2633
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASPI7602084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology