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Individual

MR. GEORGE R HATHAWAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
12197 PEVERO, TUSTIN RANCH, CA 92782-1106
(714) 389-2857
Mailing address
12197 PEVERO, TUSTIN, CA 92782-1106
(714) 389-2857

Taxonomy

Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary

Other

Enumeration date
01/26/2009
Last updated
01/26/2009
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