Provider Demographics
NPI:1679949671
Name:MOHAMED ELHASSAN, OSAMA
Entity type:Individual
Prefix:
First Name:OSAMA
Middle Name:
Last Name:MOHAMED ELHASSAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7327 E 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-6137
Mailing Address - Country:US
Mailing Address - Phone:720-499-8332
Mailing Address - Fax:
Practice Address - Street 1:7327 E 7TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-6137
Practice Address - Country:US
Practice Address - Phone:720-499-8332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-13
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver