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General NPI Number Information
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NPI Number | 1710312822
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Entity Type | Organization
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Legal Business Name | MALIBU SPECIALTY CENTER
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Dates
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Enumeration Date | 09/09/2013
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Last Update Date | 09/09/2013
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Provider Practice Location Address
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Address Line | 1746 S VICTORIA AVE STE 230
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City | VENTURA
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State | CA
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Zip | 93003-6183
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Country | US
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Telephone | 805-200-7436
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Fax | 805-642-1540
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Provider Business Mailing Address
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Address Line | 30765 PACIFIC COAST HWY STE 131
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City | MALIBU
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State | CA
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Zip | 90265-3646
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Country | US
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Telephone | 805-200-7436
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Fax | 805-642-1540
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Authorized Official
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Title or Position | OWNER
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Name | DR. SABINE HAZAN
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Credential | M.D.
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Telephone | 805-200-7436
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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