MEDICARE: ANTOINE HAGE MD

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
1	207R00000X	Internal Medicine Physician	A046166	CA
2	207RC0000X	Cardiovascular Disease Physician	A046166	CA
3	207RA0001X	Advanced Heart Failure and Transplant Cardiology Physician	A46166	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467540203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTOINE HAGE MD

Provider Business Mailing Address
First Line	:	8536 WILSHIRE BLVD FL 3
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-3103
Country	:	US
Telephone Number	:	310-248-8300
Fax Number	:	310-248-8333

Provider Business Practice Location Address
First Line	:	8536 WILSHIRE BLVD FL 3
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-3103
Country	:	US
Telephone Number	:	310-248-8300
Fax Number	:	310-248-8333

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	10/13/2017

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Directions to “ ANTOINE HAGE MD” Practice Location

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