Healthcare Provider Details

I. General information

NPI: 1821304965
Provider Name (Legal Business Name): HASSAN B HALAWI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2010
Last Update Date: 03/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2411 N BROADWAY
LOS ANGELES CA
90031-2218
US

IV. Provider business mailing address

6000 N FIGUEROA ST
LOS ANGELES CA
90042-4232
US

V. Phone/Fax

Practice location:
  • Phone: 323-987-2000
  • Fax: 323-987-1448
Mailing address:
  • Phone: 323-254-5291
  • Fax: 323-254-4618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.097823
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberE-8508
License Number StateAR
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA137111
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: