Basic Information
Provider Information
NPI: 1356838353
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AL RAWI
FirstName: DUAA
MiddleName: HASSAN
NamePrefix: DR.
NameSuffix:  
Credential: PHD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: MOHAMMAD
OtherFirstName: DUAA
OtherMiddleName: HASSAN
OtherNamePrefix: DR.
OtherNameSuffix:  
OtherCredential: PHD
OtherLastNameType: 1
Mailing Information
Address1: 51 DUDLEY LN APT 204
Address2:  
City: STANFORD
State: CA
PostalCode: 943057118
CountryCode: US
TelephoneNumber: 8576006531
FaxNumber:  
Practice Location
Address1: 300 PASTEUR DRIVE
Address2: LANE 154
City: STANFORD
State: CA
PostalCode: 94305
CountryCode: US
TelephoneNumber: 6507236661
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/16/2018
LastUpdateDate: 04/16/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  Y Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


Home