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NPI Code Detail

MEDICARE: MALVIN HAWKINS

MEDICARE: MALVIN HAWKINS
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1780840124
Entity Type Code : Individual
Provider Name (Legal Business Name) : MALVIN HAWKINS
Provider Business Mailing Address
First Line : 1030 W FLORENCE AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90044-2442
Country : US
Telephone Number : 323-839-7487
Fax Number :
Provider Business Practice Location Address
First Line : 1030 W FLORENCE AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90044-2442
Country : US
Telephone Number : 323-839-7487
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2008
Last Update Date : 01/03/2011

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