Basic Information
| Provider Information | |||||||||
| NPI: | 1659456218 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HADIA ASHRAF MD INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 903 E DEVONSHIRE AVE | ||||||||
| Address2: | # F | ||||||||
| City: | HEMET | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925433097 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9519296260 | ||||||||
| FaxNumber: | 9517652855 | ||||||||
| Practice Location | |||||||||
| Address1: | 903 E DEVONSHIRE AVE | ||||||||
| Address2: | # F | ||||||||
| City: | HEMET | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925433097 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9519291611 | ||||||||
| FaxNumber: | 9519295311 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2006 | ||||||||
| LastUpdateDate: | 12/19/2012 | ||||||||
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| AuthorizedOfficialLastName: | ASHRAF | ||||||||
| AuthorizedOfficialFirstName: | HADIA | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9519296260 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | A62197 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 00A621970 | 05 | CA | MEDICAID |