Individual
DR. LARA HASAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1100 N PALM CANYON DR, SUITE 212, PALM SPRINGS, CA 92262-4414
(760) 327-7900
(760) 327-7905
Mailing address
1100 N PALM CANYON DR, SUITE 212, PALM SPRINGS, CA 92262-4414
(760) 327-7900
(760) 327-7905
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
A141184
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174888200
—
CA
01
—
DQ488A
GROUP MEDICARE PTAN
CA
01
—
ZZZ27958Z
GROUP MEDICARE PTAN
CA
Enumeration date
07/04/2012
Last updated
08/30/2016
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