Healthcare Provider Details

I. General information

NPI: 1255353496
Provider Name (Legal Business Name): GIOVINETZA HASBUN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 11/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25751 MCBEAN PKWY STE 210
VALENCIA CA
91355-3701
US

IV. Provider business mailing address

5767 W CENTURY BLVD SUITE 400
LOS ANGELES CA
90045-5631
US

V. Phone/Fax

Practice location:
  • Phone: 661-284-3100
  • Fax: 661-290-3310
Mailing address:
  • Phone: 310-301-8707
  • Fax: 310-301-8751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA-85995
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: