Provider Demographics
NPI:1861612954
Name:HASHEM, MD ABUL (MD)
Entity type:Individual
Prefix:DR
First Name:MD ABUL
Middle Name:
Last Name:HASHEM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1133 S VERMONT AVE STE 14
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-2764
Mailing Address - Country:US
Mailing Address - Phone:213-487-6300
Mailing Address - Fax:213-487-2495
Practice Address - Street 1:1133 S VERMONT AVE STE 14
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-2764
Practice Address - Country:US
Practice Address - Phone:213-487-6300
Practice Address - Fax:213-487-2495
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44484122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist