1215196993 NPI number — TAHER MOHAMED HEGAB B.PHARM PH.D

Table of content: TAHER MOHAMED HEGAB B.PHARM PH.D (NPI 1215196993)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215196993 NPI number — TAHER MOHAMED HEGAB B.PHARM PH.D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HEGAB
Provider First Name:
TAHER
Provider Middle Name:
MOHAMED
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
B.PHARM PH.D
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HEGAB
Provider Other First Name:
TAHER
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RPH PHD
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1215196993
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/13/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7246 N LAVAL AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRESNO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93720-0323
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
559-940-3831
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2990 E NEES AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRESNO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93720-6008
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-297-4301
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/06/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  60535 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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