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Individual

BRENDA N HAYAKAWA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1350 W COVINA BLVD, SAN DIMAS, CA 91773-3245
(909) 599-6811
(818) 587-2493
Mailing address
PO BOX 4419, WOODLAND HILLS, CA 91365-4419
(800) 358-9787
(818) 587-2493

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G63803
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00G638030
BLUE SHIELD
CA
05
00G638030
CA
01
930096375
RAILROAD MEDICARE
CA
Enumeration date
05/19/2006
Last updated
07/18/2007
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