Provider Demographics
NPI:1396158648
Name:HAZBOUN, RAJAIE GEORGE (MD, MBA)
Entity type:Individual
Prefix:DR
First Name:RAJAIE
Middle Name:GEORGE
Last Name:HAZBOUN
Suffix:
Gender:M
Credentials:MD, MBA
Other - Prefix:
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Mailing Address - Street 1:PO BOX 19638
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62794-9638
Mailing Address - Country:US
Mailing Address - Phone:217-545-4401
Mailing Address - Fax:217-545-1793
Practice Address - Street 1:2400 CLAY ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-1809
Practice Address - Country:US
Practice Address - Phone:415-567-7000
Practice Address - Fax:415-567-7011
Is Sole Proprietor?:No
Enumeration Date:2014-06-04
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA143928208600000X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery