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Individual

BRUCE EDWARD HACKMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSW

Contact information

Practice address
255 W 5TH ST, UNIT 616, SAN PEDRO, CA 90731-3388
(310) 707-7489
Mailing address
255 W 5TH ST, UNIT 616, SAN PEDRO, CA 90731-3388
(310) 707-7489

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
31994
CA

Other

Enumeration date
12/30/2011
Last updated
12/30/2011
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