Individual
CHARLES PATRICK HAZEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
1403 LOMITA BLVD, 2ND FLOOR, HARBOR CITY, CA 90710-2076
(310) 534-6223
(310) 326-7205
Mailing address
1403 LOMITA BLVD, 2ND FLOOR, HARBOR CITY, CA 90710-2076
(310) 534-6223
(310) 326-7205
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
OT013853
PA
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
20A12785
CA
Other
Enumeration date
07/19/2010
Last updated
12/02/2021
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