Healthcare Provider Details

I. General information

NPI: 1780848085
Provider Name (Legal Business Name): GENEVIEVE LILLEY HASEK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2008
Last Update Date: 02/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22411 HAWTHORNE BLVD TORRANCE MEMORIAL URGENT CARE
TORRANCE CA
90505-2507
US

IV. Provider business mailing address

3330 LOMITA BLVD
TORRANCE CA
90505-5002
US

V. Phone/Fax

Practice location:
  • Phone: 310-784-3740
  • Fax: 310-375-1392
Mailing address:
  • Phone: 310-325-9110
  • Fax: 310-784-3789

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA110835
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD447288
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: