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NPI Code Detail

MEDICARE: HYATT HASSAN

MEDICARE: HYATT HASSAN
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1598693368
Entity Type Code : Individual
Provider Name (Legal Business Name) : HYATT HASSAN
Provider Business Mailing Address
First Line : 100 N PACIFIC COAST HWY
Second Line :
City : EL SEGUNDO
State : CA
Zip : 90245-4359
Country : US
Telephone Number : 424-296-0126
Fax Number :
Provider Business Practice Location Address
First Line : 100 N PACIFIC COAST HWY
Second Line :
City : EL SEGUNDO
State : CA
Zip : 90245-4359
Country : US
Telephone Number : 424-296-0126
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2026
Last Update Date : 05/12/2026

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Directions to “ HYATT HASSAN ” Practice Location

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