Provider Demographics
NPI:1548320831
Name:HAAS, NEIL BERNARD (MD)
Entity type:Individual
Prefix:DR
First Name:NEIL
Middle Name:BERNARD
Last Name:HAAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1800 FAIRBURN AVE
Mailing Address - Street 2:SUITE 211
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-5958
Mailing Address - Country:US
Mailing Address - Phone:310-475-5532
Mailing Address - Fax:310-475-6296
Practice Address - Street 1:1800 FAIRBURN AVE
Practice Address - Street 2:SUITE 211
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-5958
Practice Address - Country:US
Practice Address - Phone:310-475-5532
Practice Address - Fax:310-475-6296
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC296762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
A87354Medicare UPIN
C29676Medicare ID - Type Unspecified