Basic Information
Provider Information
NPI: 1033559679
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HADZIC
FirstName: TARIK
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D., PH.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 26135 MUREAU RD
Address2: SUITE 101
City: CALABASAS
State: CA
PostalCode: 913023182
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 26135 MUREAU RD
Address2: SUITE 101
City: CALABASAS
State: CA
PostalCode: 913023182
CountryCode: US
TelephoneNumber: 8444969160
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/27/2013
LastUpdateDate: 05/09/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800XA141667CAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
2084P0800X2013017833MON Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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