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Individual

DR. JAMES HAGELE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
400 SIERRA COLLEGE DRIVE, SUITE A, GRASS VALLEY, CA 95945-5089
(530) 272-3411
(530) 272-3474
Mailing address
400 SIERRA COLLEGE DRIVE, SUITE A, GRASS VALLEY, CA 95945-5089
(530) 272-3411
(530) 272-3474

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
A20144
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A20144
LICENSE
CA
01
A201440
MEDI CAL RENDERING NUMBER
CA
Enumeration date
06/29/2006
Last updated
07/09/2007
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