De Jager, Hendrik Johannes

De Jager, Hendrik Johannes is an sole proprietor health care provider with primary practice located at 1850 S Waterman Ave Suite A, San Bernardino CA 92408-2852. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. De Jager, Hendrik Johannes can be contacted via phone (909) 796-2525.

Contact Information

Primary practice address
1850 S Waterman Ave Suite A San Bernardino CA 92408-2852
Phone: (909) 796-2525
Fax: (909) 824-2028
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X A252550 California

Profile Details

NPI number 1043398282
LBN Legal business name De Jager, Hendrik Johannes
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 2nd, 2006
Last updated Jun 24th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043398282 NPPES
California MEDICAID 00A252550

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