Hagstrom, Liv S.

Hagstrom, Liv S. is an individual health care provider with primary practice located at 2121 Santa Monica Blvd , Santa Monica CA 90404-2303. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Hagstrom, Liv S. can be contacted via phone (310) 829-8618.

Contact Information

Primary practice address
2121 Santa Monica Blvd Santa Monica CA 90404-2303
Phone: (310) 829-8618
Fax: (310) 829-8607
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA10004777 Washington

Profile Details

NPI number 1811986672
LBN Legal business name Hagstrom, Liv S.
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 14th, 2005
Last updated Apr 13th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811986672 NPPES
Washington MEDICAID 8413650

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