Individual
CHRISTIAN HACKSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5176 HILL RD E, EMERGENCY DEPARTMENT, LAKEPORT, CA 95453-6300
(707) 262-5050
(707) 262-5053
Mailing address
3843 GLEBE RD, KELSEYVILLE, CA 95451-8251
(707) 295-6080
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
C51195
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C511950
—
CA
Enumeration date
06/14/2006
Last updated
06/26/2008
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