Organization
SUHAIL I HAWATT MD
Active
Other names
SUHAIL I HAWATT MD
Organization subpart
No
Provider details
NPI number
Authorized official
DIRENDIA SHACKELFORD (MANAGED CARE SPECIALIST)
(800) 654-0889
Entity
Organization
Contact information
Practice address
23961 CALLE DE LA MAGDALENA STE 517, LAGUNA HILLS, CA 92653-7628
(949) 830-4082
(949) 830-4344
Mailing address
23961 CALLE DE LA MAGDALENA STE 517, LAGUNA HILLS, CA 92653-7628
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
C37808
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5602102
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
10/23/2006
Last updated
06/16/2008
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