Individual
DR. JARED HAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4822 NEWPORT AVE, SAN DIEGO, CA 92107-3111
(509) 869-5926
Mailing address
4822 NEWPORT AVE, SAN DIEGO, CA 92107-3111
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
14385TLG
CA
152W00000X
Optometrist
3419ATI
OR
Other
Enumeration date
10/07/2009
Last updated
06/13/2016
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