Hagen, Jeffrey Lars

Hagen, Jeffrey Lars is an individual health care provider with primary practice located at 5400 W Hillsdale Ave , Visalia CA 93291-8222. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, Podiatric Medicine & Surgery Service Providers / Podiatrist. Podiatric Medicine & Surgery Service Providers / Podiatrist is his primary health care specialty. Hagen, Jeffrey Lars can be contacted via phone (559) 738-7500.

Contact Information

Primary practice address
5400 W Hillsdale Ave Visalia CA 93291-8222
Phone: (559) 738-7500
Fax: (559) 734-2055
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X E4634 California
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X PO807 Washington
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X E4634 California

Profile Details

NPI number 1093792723
LBN Legal business name Hagen, Jeffrey Lars
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 23rd, 2005
Last updated Oct 3rd, 2016 - about 8 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 1093792723 NPPES
California MEDICAID 1366570772
California Other 1366570772

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