Provider Demographics
NPI:1215565601
Name:HEER, HAILEY (MD)
Entity Type:Individual
Prefix:
First Name:HAILEY
Middle Name:
Last Name:HEER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HAILEY
Other - Middle Name:
Other - Last Name:HOGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:969 HILGARD AVE APT 605
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-3052
Mailing Address - Country:US
Mailing Address - Phone:949-500-1253
Mailing Address - Fax:
Practice Address - Street 1:800 FAIRMOUNT AVE STE 310
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3153
Practice Address - Country:US
Practice Address - Phone:626-449-7350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-31
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA185434208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program