Provider Demographics
NPI:1649582594
Name:HAZANY, SALAR (MD)
Entity Type:Individual
Prefix:DR
First Name:SALAR
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 1:720 WESTVIEW DR SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30310-1458
Mailing Address - Country:US
Mailing Address - Phone:404-752-1857
Mailing Address - Fax:404-752-1088
Practice Address - Street 1:1000 NEWBURY RD 240
Practice Address - Street 2:
Practice Address - City:NEWBURY PARK
Practice Address - State:CA
Practice Address - Zip Code:91320-6443
Practice Address - Country:US
Practice Address - Phone:805-498-1400
Practice Address - Fax:805-498-1411
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-08
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA118281207N00000X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery