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Individual

JAMES M HAGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
175 PARK ST, LAKEPORT, CA 95453-4803
(707) 263-9595
(707) 263-5576
Mailing address
175 PARK ST, LAKEPORT, CA 95453-4803
(707) 263-9595
(707) 263-5576

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E1538
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
480028898
RAILROAD MEDICARE
CA
Enumeration date
05/24/2005
Last updated
03/21/2011
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