person
Ms. Liv S. Hagstrom, PA-C
Surgical Physician Assistant in Santa Monica, California
NPI 1811986672

Liv S. Hagstrom is a Surgical Physician Assistant based in Boston, CA and is specialized in Surgical. Liv S. Hagstrom practices in Santa Monica, CA and has the professional credentials of PA-C. The NPI Number for Liv S. Hagstrom is 1811986672 and holds a License No. PA10004777 (California).

The current practice location address for Liv S. Hagstrom is 2121 Santa Monica Blvd, Santa Monica, CA and can be reached out via phone at 310-829-8618 and via fax at 310-829-8607.

Location: 2121 Santa Monica Blvd, Santa Monica, CA, 02115-6110
person
Provider Profile Details
NPI Number
1811986672
Provider Name
Liv S. Hagstrom
Credential
PA-C
Provider Entity Type
Individual
Gender
Female
Address
2121 Santa Monica Blvd, Santa Monica, CA, 02115-6110
Phone Number
310-829-8618
Fax Number
310-829-8607
Provider Enumeration Date
10/14/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
8413650 05 WA
institution
Provider Business Practice Location Address Details
Address
2121 Santa Monica Blvd
City
State
Zip
90404-2303
Phone Number
310-829-8618
Fax Number
310-829-8607
person
Provider Business Mailing Address Details
Address
2121 Santa Monica Blvd
City
State
Zip
90404-2303
Phone Number
310-829-8618
Fax Number
310-829-8607
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
PA10004777 (Washington)
Definition
Definition to come...
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