Healthcare Provider Details

I. General information

NPI: 1093667909
Provider Name (Legal Business Name): SALAR HAZANY MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2026
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 N RODEO DR STE T13
BEVERLY HILLS CA
90210-4558
US

IV. Provider business mailing address

1000 NEWBURY RD STE 240
NEWBURY PARK CA
91320-6443
US

V. Phone/Fax

Practice location:
  • Phone: 310-571-8435
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SALAR HAZANY
Title or Position: PRESIDENT
Credential: MD
Phone: 210-900-2293