Provider Demographics
NPI:1023123288
Name:AHMED, SYED HASNAT (MD)
Entity type:Individual
Prefix:DR
First Name:SYED
Middle Name:HASNAT
Last Name:AHMED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:S
Other - Middle Name:HASNAT
Other - Last Name:AHMED
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 23058
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92193-3058
Mailing Address - Country:US
Mailing Address - Phone:858-292-4022
Mailing Address - Fax:858-291-1287
Practice Address - Street 1:1271 ROSS AVE
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-4304
Practice Address - Country:US
Practice Address - Phone:760-335-3030
Practice Address - Fax:760-335-3035
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA54334207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A543340Medicaid
CAP00228825OtherRR MEDICARE PIN #
CAG97383Medicare UPIN
CAWA54334BMedicare PIN