# HAYASA MEDICAL GROUP INC

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

## Provider details

- **NPI number:** 1871811448
- **Authorized official:** SAMUEL LEE DRAKE M.D, (CEO)
- **Authorized official phone:** (213) 382-2063

## Contact information

- **Practice address:** 3540 WILSHIRE BLVD, SUITE 714, LOS ANGELES, CA 90010-2307
- **Practice address phone:** (213) 382-2063
- **Practice address fax:** (213) 382-4935
- **Mailing address:** 3540 WILSHIRE BLVD, SUITE 714, LOS ANGELES, CA 90010-2307
- **Mailing address phone:** (213) 382-2063
- **Mailing address fax:** (213) 382-4935

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/06/2010
- **Last updated:** 05/06/2010