Provider Demographics
NPI:1710312822
Name:MALIBU SPECIALTY CENTER
Entity Type:Organization
Organization Name:MALIBU SPECIALTY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SABINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAZAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-200-7436
Mailing Address - Street 1:30765 PACIFIC COAST HWY
Mailing Address - Street 2:STE 131
Mailing Address - City:MALIBU
Mailing Address - State:CA
Mailing Address - Zip Code:90265-3646
Mailing Address - Country:US
Mailing Address - Phone:805-200-7436
Mailing Address - Fax:805-642-1540
Practice Address - Street 1:1746 S VICTORIA AVE
Practice Address - Street 2:STE 230
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-6183
Practice Address - Country:US
Practice Address - Phone:805-200-7436
Practice Address - Fax:805-642-1540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-09
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty