Paul Nolan Hazelbaker, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

20A7147 Issued in CA

Practice address

1250 6TH Ave
Suite 100
San Diego, CA 92101-4300

Phone

(619) 515-2430

Fax

(619) 578-2410

NPI assigned

Aug 1, 2006

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Family Health Centers of San Diego, Inc

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1447281936
  Medicare reassignment NPD
• Family Health Centers of San Diego Inc

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1952729303
  NPD
• Family Health Centers of San Diego, Inc

  • Federally Qualified Health Center (FQHC)
  • Escondido, CA
  • NPI 1356178180
  NPD
• North County Health Project Inc

  • Federally Qualified Health Center (FQHC)
  • San Marcos, CA
  • NPI 1588489975
  NPD (past)

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508371200000",
    "number": "1831106103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 GATEWAY CENTER WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024541",
            "telephone_number": "619-515-2300",
            "fax_number": "619-906-4564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 6TH AVE",
            "address_2": "SUITE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921014300",
            "telephone_number": "619-515-2430",
            "fax_number": "619-578-2410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZELBAKER",
        "first_name": "PAUL",
        "middle_name": "NOLAN",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2017-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A7147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey Ann Haywood, MSW
• Umer Hayyat, MD
• Victoria Marie Hazard
• Kevin Daryl Hazel
• Tiffany Nicole Hazel
• Hazelden Betty Ford Foundation
• Crystal Hazelton, MPT
• Elizabeth Lynne Hazelton, RCP, RRT
• Ellyn Ann Hazelton, L.C.S.W.
• Michele Hazelwood

• Internal Medicine Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.