Individual
HAYDAR HASAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
506 E WESTERN AVE STE 104, AVONDALE, AZ 85323-2422
(602) 230-7373
Mailing address
3101 N CENTRAL AVE STE 550, PHOENIX, AZ 85012-2635
(602) 230-7373
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8993
AZ
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
8993
AZ
Other
Enumeration date
01/25/2022
Last updated
04/22/2025
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