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Individual
DR. JEFFREY LARS HAGEN
Active
Individual
DR. JEFFREY LARS HAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E4634
CA
213ES0103X
Foot & Ankle Surgery Podiatrist
E4634
CA
213ES0103X
Foot & Ankle Surgery Podiatrist
PO807
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1366570772
GROUP NPI
CA
05
—
1366570772
—
CA
Enumeration date
12/23/2005
Last updated
10/03/2016
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