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General NPI Number Information
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NPI Number | 1093253437
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Entity Type | Individual
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Provider Name | SARAH HAZANY PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/06/2017
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Last Update Date | 07/31/2020
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Provider Practice Location Address
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Address Line | 1000 NEWBURY RD STE 240
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City | NEWBURY PARK
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State | CA
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Zip | 91320-6443
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Country | US
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Telephone | 818-665-5717
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 NEWBURY RD STE 240
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City | NEWBURY PARK
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State | CA
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Zip | 91320-6443
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Country | US
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Telephone | 818-665-5717
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 58317
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License Number State | CA
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