Healthcare Provider Details

I. General information

NPI: 1750512448
Provider Name (Legal Business Name): DR. SANDRA HAWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2009
Last Update Date: 09/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1453 16TH ST
SANTA MONICA CA
90404-2715
US

IV. Provider business mailing address

120 SOUTH MENTOR AVENUE UNIT #301
PASADENA CA
91106
US

V. Phone/Fax

Practice location:
  • Phone: 310-264-6646
  • Fax:
Mailing address:
  • Phone: 626-456-3200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: