# POWERPLAY MD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205162013
- **Authorized official:** DR. LYDIE HAZAN MD (CEO/PRESIDENT)
- **Authorized official phone:** (310) 289-8242

## Contact information

- **Practice address:** 5800 WILSHIRE BOULEVARD, LOS ANGELES, CA 90036
- **Practice address phone:** (310) 289-8242
- **Practice address fax:** (310) 289-8248
- **Mailing address:** 5800 WILSHIRE BOULEVARD, LOS ANGELES, CA 90036
- **Mailing address phone:** (310) 289-8242
- **Mailing address fax:** (310) 289-8248

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133VN1004X | Pediatric Nutrition Registered Dietitian | A53116 | CA | Yes |

## Other

- **Enumeration date:** 10/29/2009
- **Last updated:** 10/29/2009