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General NPI Number Information
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NPI Number | 1891219531
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Entity Type | Individual
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Provider Name | MATTHEW HASLEY
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Gender | Male
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Dates
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Enumeration Date | 08/02/2017
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Last Update Date | 03/09/2022
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Provider Practice Location Address
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Address Line | 5154 W SUNSET BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90027-5708
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Country | US
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Telephone | 323-663-3951
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Fax |
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Provider Business Mailing Address
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Address Line | 4229 W ROSECRANS AVE UNIT 13
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City | HAWTHORNE
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State | CA
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Zip | 90250-7266
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Country | US
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Telephone | 631-456-7072
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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