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NPI Code Detail

MEDICARE: DIANA HAZIM

MEDICARE: DIANA HAZIM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835P1200XPharmacotherapy Pharmacist14247NV

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1435654378OTHERNVMEDICARE, MEDICAID

General Provider Information

NPI Number : 1306212113
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANA HAZIM
Provider Business Mailing Address
First Line : 10250 W CHARLESTON BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89135-1020
Country : US
Telephone Number : 925-467-3349
Fax Number :
Provider Business Practice Location Address
First Line : 10250 W CHARLESTON BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89135-1020
Country : US
Telephone Number : 925-467-3349
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2015
Last Update Date : 08/15/2015

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Directions to “ DIANA HAZIM ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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