Provider Demographics
NPI:1225043185
Name:HAZANY, RAMIN (MD)
Entity Type:Individual
Prefix:
First Name:RAMIN
Middle Name:
Last Name:HAZANY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10719 ROCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-5033
Mailing Address - Country:US
Mailing Address - Phone:310-680-0560
Mailing Address - Fax:310-680-0565
Practice Address - Street 1:323 N PRAIRIE AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-4502
Practice Address - Country:US
Practice Address - Phone:310-680-0560
Practice Address - Fax:310-680-0565
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA724832081P0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA72483Medicare ID - Type Unspecified