Provider Demographics
NPI:1538918842
Name:YASSA, MINA WAGEH GAMEEL
Entity type:Individual
Prefix:
First Name:MINA
Middle Name:WAGEH GAMEEL
Last Name:YASSA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 MINNESOTA ST APT 441
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-3027
Mailing Address - Country:US
Mailing Address - Phone:626-591-6049
Mailing Address - Fax:
Practice Address - Street 1:600 MINNESOTA ST APT 441
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107-3027
Practice Address - Country:US
Practice Address - Phone:626-591-6049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-17
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program