Individual
JUSTIN HATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11406 LOMA LINDA DR # 300, LOMA LINDA, CA 92354-3711
(909) 558-6277
(909) 558-6278
Mailing address
11406 LOMA LINDA DR, #300, LOMA LINDA, CA 92354
(909) 558-6277
(909) 558-6278
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
A86728
CA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
A86728
CA
Other
Enumeration date
07/26/2007
Last updated
05/24/2017
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