1245283613 NPI number — HANY HALAWA M.D.

Table of content: HANY HALAWA M.D. (NPI 1245283613)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245283613 NPI number — HANY HALAWA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HALAWA
Provider First Name:
HANY
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245283613
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/27/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2374 E PACIFICA PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RANCHO DOMINGUEZ
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90220-6214
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-225-3244
Provider Business Mailing Address Fax Number:
310-698-7054

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4101 TORRANCE BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TORRANCE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-225-3244
Provider Business Practice Location Address Fax Number:
310-698-7054
Provider Enumeration Date:
05/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207ZP0102X , with the licence number:  A56429 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00A564290 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4301062430 . This is a "MEDICAL LICENSE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 13715 . This is a "MEDICAL LICENSE" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: A56429 . This is a "MEDICAL LICENSE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 42828 . This is a "MEDICAL LICENSE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".




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