Hagemann, David Shane

Hagemann, David Shane is an individual health care provider with primary practice located at 1412 Blue Oaks Blvd , Roseville CA 95747-7143. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Hagemann, David Shane can be contacted via phone (916) 784-7546.

Contact Information

Primary practice address
1412 Blue Oaks Blvd Roseville CA 95747-7143
Phone: (916) 784-7546
Fax: (916) 784-7548
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA147050 California

Profile Details

NPI number 1881675619
LBN Legal business name Hagemann, David Shane
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 9th, 2005
Last updated Mar 15th, 2023 - about last year

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 1881675619 NPPES
California Other OPA147050 BLUE SHIELD
California MEDICAID OPA147050 BLUE SHIELD

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