Individual
HAZEL MCKILLOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12900 AVALON BLVD, LOS ANGELES, CA 90061-2734
(310) 370-5888
Mailing address
P.O. BOX 2199, 1455 W REDONDO BLVD, GARDENA, CA 90247
(310) 370-5888
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
A50837
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A508371
—
CA
Enumeration date
07/21/2006
Last updated
08/19/2015
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