Provider Demographics
NPI:1780848085
Name:HASEK, GENEVIEVE LILLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:GENEVIEVE
Middle Name:LILLEY
Last Name:HASEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3330 LOMITA BLVD
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-5002
Mailing Address - Country:US
Mailing Address - Phone:310-325-9110
Mailing Address - Fax:310-784-3789
Practice Address - Street 1:22411 HAWTHORNE BLVD
Practice Address - Street 2:TORRANCE MEMORIAL URGENT CARE
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-2507
Practice Address - Country:US
Practice Address - Phone:310-784-3740
Practice Address - Fax:310-375-1392
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA110835207P00000X
PAMD447288207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine