Basic Information
| Provider Information | |||||||||
| NPI: | 1437281813 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAO | ||||||||
| FirstName: | TOM | ||||||||
| MiddleName: | WEI | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | M.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1968 W ADAMS BLVD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900183515 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6269359224 | ||||||||
| FaxNumber: | 3237337651 | ||||||||
| Practice Location | |||||||||
| Address1: | 12450 VAN NUYS BLVD STE 100 | ||||||||
| Address2: | |||||||||
| City: | PACOIMA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913311392 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8188968366 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/12/2007 | ||||||||
| LastUpdateDate: | 08/05/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | LMFT #49662 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.