| Thomas B Hazlehurst, M.d. | |
|
1900 Sullivan Ave Daly City CA 94015-2200 | |
| (650) 400-0277 | |
| (650) 340-1785 |
| Full Name | Thomas B Hazlehurst, M.d. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1900 Sullivan Ave, Daly City, California |
| Authorized Official Name and Position | Thomas B Hazlehurst (CEO) |
| Authorized Official Contact | 6504000277 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas B Hazlehurst, M.d. 39159 Paseo Padre Pkwy Suite 203 Fremont CA 94538-1608 Ph: (510) 505-1091 | Thomas B Hazlehurst, M.d. 1900 Sullivan Ave Daly City CA 94015-2200 Ph: (650) 400-0277 |
| NPI Number | 1205846789 |
|---|---|
| Provider Enumeration Date | 08/08/2006 |
| Last Update Date | 03/12/2014 |
| Medicare PECOS PAC ID | 7315980414 |
|---|---|
| Medicare Enrollment ID | O20050609000558 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205846789 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | G37365 (California) | Primary |
| Provider Name | Donna Maria Puzon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801949524 PECOS PAC ID: 2567555717 Enrollment ID: I20070905000308 |
| Provider Name | Thomas B Hazlehurst |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1205846771 PECOS PAC ID: 4486697588 Enrollment ID: I20100723000629 |
| Provider Name | Celso Q Huiso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144624958 PECOS PAC ID: 4587967021 Enrollment ID: I20160118000009 |
| Provider Name | Soraya Mangondato-galvan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881755072 PECOS PAC ID: 7517219629 Enrollment ID: I20181017001866 |
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Ellick Tsang M D Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1800 Sullivan Ave, Suite 304, Daly City, CA 94015 Phone: 650-992-8484 Fax: 650-992-8480 | |
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