Individual
MRS. DIANE L HAUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDHAP
Contact information
Practice address
10736 JEFFERSON BLVD # 411, CULVER CITY, CA 90230-4933
(310) 617-2302
(310) 572-6062
Mailing address
10736 JEFFERSON BLVD # 411, CULVER CITY, CA 90230-4933
(310) 617-2302
(310) 572-6062
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
11303
CA
124Q00000X
Dental Hygienist
Primary
HAP 38
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11303
DELTA DENTAL
CA
01
—
147044
DELTA DENTAL OF CALIFORNI
—
05
—
H00038-01
—
CA
Enumeration date
01/24/2007
Last updated
05/28/2009
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