Theodore J Hak, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G46097 Issued in CA

Practice address

901 Wilshire Blvd FL 3
Santa Monica, CA 90401-1854

Phone

(310) 829-8903

Fax

(424) 212-5933

NPI assigned

Jun 17, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Perelman School of Med at the University of Pennsylvania, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Saint Johns Medical FoundationGroup PAC ID 0840548624, 282 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: thak473288@oc.providencedirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Providence Saint Johns Medical Foundation

  • Specialist
  • Santa Monica, CA
  • NPI 1770093734

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Santa Monica Bay Area Physicians

  • Family Medicine Physician
  • Culver City, CA
  • NPI 1770608432
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1457396269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 WILSHIRE BLVD FL 3",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904011854",
            "telephone_number": "310-829-8903",
            "fax_number": "424-212-5933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 WILSHIRE BLVD FL 3",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904011854",
            "telephone_number": "310-829-8903",
            "fax_number": "424-212-5933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAK",
        "first_name": "THEODORE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G46097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liv S. Hagstrom, PA-C
• Romana Haider, M.D.
• Eiftu Solomon Haile
• Stacy Kitter Hajarian, LMFT
• Maryam Hajiabbasi, MD
• Nahal Hakim, PHARMD
• Tiffany Hakim
• Solemon Hakimi, M.D.
• Roobina Hakoopian, FNP
• Mariam Samir Halaka, DDS

• Family Medicine Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.