Provider Demographics
NPI:1790703742
Name:HECHT, JOEL RANDOLPH (MD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:RANDOLPH
Last Name:HECHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5767 W CENTURY BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5632
Mailing Address - Country:US
Mailing Address - Phone:310-586-2097
Mailing Address - Fax:310-586-0841
Practice Address - Street 1:200 MEDICAL PLAZA
Practice Address - Street 2:#365,420,530,120
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095
Practice Address - Country:US
Practice Address - Phone:310-586-2097
Practice Address - Fax:310-586-0841
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG63119207RG0100X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G631190Medicaid
CA00G631190Medicaid
CAWG63119AMedicare PIN
CAWG63119DMedicare PIN