TYSON A. HADDUCK (NPI# 1336409382) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336409382 |
| Entity Type | Individual |
| Full Name | TYSON A. HADDUCK |
| Credential | M.D. |
| Practice Address |
10833 Le Conte Ave Los Angeles CA 90095-3075 |
| Mailing Address |
5767 W Century Blvd Ste 400 Los Angeles CA 90095-5631 |
| Practice Telephone | 3103016800 |
| Mailing Telephone | (310) 267-8796 |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2017-08-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
A127728 | CA | Allopathic & Osteopathic Physicians |
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
A127728 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
10833 LE CONTE AVE |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90095-3075 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598761942 | Dennis Goldfinger | Specialist | 10833 Le Conte Ave, Los Angeles, CA 90095-3075 | 2005-06-21 |
| 1972129427 | Matthew Joseph Heinz | Student in an Organized Health Care Education/Training Program | 10833 Le Conte Ave, Los Angeles, CA 90095-3075 | 2020-06-21 |
| 1255955803 | Airton D Soares | Student in an Organized Health Care Education/Training Program | 10833 Le Conte Ave, Los Angeles, CA 90095-3075 | 2020-05-29 |
| 1073137626 | Gonzalo Nicolas Olaverria Salavaggione | Student in an Organized Health Care Education/Training Program | 10833 Le Conte Ave, Los Angeles, CA 90095-3075 | 2020-05-29 |
| 1780204990 | Maira Hinojosa | Student in an Organized Health Care Education/Training Program | 10833 Le Conte Ave, Los Angeles, CA 90095-3075 | 2020-04-17 |
| 1053930537 | Jeong Min Kim | Student in an Organized Health Care Education/Training Program | 10833 Le Conte Ave, Los Angeles, CA 90095-3075 | 2020-04-14 |
| 1972122778 | Mojan Mirnia | Student in an Organized Health Care Education/Training Program | 10833 Le Conte Ave, Los Angeles, CA 90095-3075 | 2020-04-11 |
| 1902435779 | Kaitlin Elizabeth Fusco | Student in an Organized Health Care Education/Training Program | 10833 Le Conte Ave, Los Angeles, CA 90095-3075 | 2020-04-03 |
| 1487283313 | Jonathan Douglas Gatto | Student in an Organized Health Care Education/Training Program | 10833 Le Conte Ave, Los Angeles, CA 90095-3075 | 2020-04-02 |
| 1578191839 | Abhishek Venkataramana | Student in an Organized Health Care Education/Training Program | 10833 Le Conte Ave, Los Angeles, CA 90095-1430 | 2020-03-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982212155 | Alexandra Gubin | Social Worker | Ucla, 757 Westwood Medical Plaza, Los Angeles, CA 90095 | 2020-07-14 |
| 1952926263 | Georgina Parra | Student in an Organized Health Care Education/Training Program | 10833 Le Conteave, Los Angeles, CA 90095 | 2020-06-11 |
| 1609403575 | Yagmur Muftuoglu | Student in an Organized Health Care Education/Training Program | 757 Westwood Plaza, Neurosurgery, Los Angeles, CA 90095 | 2020-03-23 |
| 1619438173 | Brandon Covington Smith | Student in an Organized Health Care Education/Training Program | 727 Westwood Plaza, Dept of Internal Medicine, Los Angeles, CA 90095 | 2019-03-27 |
| 1184184913 | Alexander Daniel Yuen | Student in an Organized Health Care Education/Training Program | 757 Westwood Plaza (internal Medicine), Los Angeles, CA 90095 | 2019-03-19 |
| 1790266369 | Dana Saifan | Student in an Organized Health Care Education/Training Program | 1000 Veteran Avenue, Los Angeles, CA 90095 | 2018-08-22 |
| 1427549146 | Courtney Renee' Real | Registered Nurse | 757 Westwood Plz Ste 6236, Los Angeles, CA 90095 | 2018-05-29 |
| 1932605094 | Akash Atul Shah | Student in an Organized Health Care Education/Training Program | Ucla Department of Orthopaedic Surgery, 10833 Le Conte Avenue, 76-116 Chs, Los Angeles, CA 90095 | 2018-04-05 |
| 1316443435 | Dane Jensen Brodke | Orthopaedic Surgery | 757 Westwood Plaza, (orthopaedic Surgery), Los Angeles, CA 90095 | 2018-04-05 |
| 1477058824 | Thomas William Gaither Castellanos | Student in an Organized Health Care Education/Training Program | 757 Westwood Plaza, Urology, Los Angeles, CA 90095 | 2018-03-28 |
| Find all providers in zip 90095 | ||||
| Taxonomy Code | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366084535 | Luo Xu | Radiology | 757 Westwood Plz # 2146, Los Angeles, CA 90095-8358 | 2019-10-09 |
| 1801138151 | Noah A Brauner | Radiology | 1200 N State Street, D&t 3d321, Los Angeles, CA 90033 | 2013-03-25 |
| 1346508827 | Frank Hao | Radiology | 11301 Wilshire Blvd # 114, Los Angeles, CA 90073-1003 | 2012-05-02 |
| 1578882965 | Pacific Vascucare, Inc. | Radiology | 1660 W 3rd St, Los Angeles, CA 90017-1138 | 2010-05-25 |
| 1841348711 | Ata Daniel Rezvanpour | Radiology | 6041 Cadillac Ave., Los Angeles, CA 90034-1702 | 2007-01-08 |
| 1730649120 | Elizabeth Herzog | Radiology | 4733 W Sunset Blvd Fl 3, Los Angeles, CA 90027-6021 | 2019-03-21 |
| 1902332471 | Peter Hu | Radiology | 1200 N. State Street, D&t 3d321, Los Angeles, CA 90033 | 2017-05-03 |
| 1982135315 | Shimwoo Lee | Radiology | 757 Westwood Plz Ste 1638, Los Angeles, CA 90095-2302 | 2017-03-27 |
| 1366981581 | Ali Golshan Md Inc | Radiology | 11633 San Vicente Blvd Ste 240, Los Angeles, CA 90049-6513 | 2017-02-21 |
| 1891140844 | Brian Boa-yen Ng | Radiology | 1200 N State St, Los Angeles, CA 90033-1029 | 2016-04-27 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90095 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.