Individual
HASSAN SHEIKH MOGHADDAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
15332 LAKESHORE DR STE 101, CLEARLAKE, CA 95422
(707) 461-7986
Mailing address
15332 LAKESHORE DR STE 101, CLEARLAKE, CA 95422-9761
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A142083
CA
208600000X
Surgery Physician
MT207360
PA
Other
Enumeration date
07/10/2013
Last updated
06/26/2018
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