Individual
KHALED MAHMOUD HASSAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2720 N HARBOR BLVD, STE 220, FULLERTON, CA 92835-2609
(714) 578-8527
(714) 578-8570
Mailing address
2720 N HARBOR BLVD, STE 220, FULLERTON, CA 92835-2609
(714) 578-8527
(714) 578-8570
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
A111137
CA
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
A111137
CA
207ND0900X
Dermatopathology Physician
A111137
CA
207NS0135X
Procedural Dermatology Physician
A111137
CA
Other
Enumeration date
07/15/2008
Last updated
11/03/2021
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