Healthcare Provider Details

I. General information

NPI: 1275265092
Provider Name (Legal Business Name): DWCH HOLDINGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2022
Last Update Date: 06/01/2023
Certification Date: 06/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 W LA VETA AVE STE 300
ORANGE CA
92868-4246
US

IV. Provider business mailing address

17525 VENTURA BLVD STE 21017525
ENCINO CA
91316-3843
US

V. Phone/Fax

Practice location:
  • Phone: 714-598-1745
  • Fax:
Mailing address:
  • Phone: 818-986-2861
  • Fax: 818-638-5762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DUKE WILLIAM CLIFFORD HASSON
Title or Position: OWNER AND PHYSICIAN
Credential: MD
Phone: 714-598-1745