MEDICARE: ROBERT HASKELL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	A125983	CA

General Provider Information

NPI Number	:	1558686501
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT HASKELL M.D.

Provider Business Mailing Address
First Line	:	2516 MOUNT BEACON TER
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90068-2444
Country	:	US
Telephone Number	:	917-584-8045
Fax Number	:

Provider Business Practice Location Address
First Line	:	2516 MOUNT BEACON TER
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90068-2444
Country	:	US
Telephone Number	:	917-584-8045
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2010
Last Update Date	:	04/21/2023

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