Healthcare Provider Details

I. General information

NPI: 1306928700
Provider Name (Legal Business Name): JOHN M HASSLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1223 ROSLYN LN
LA JOLLA CA
92037-3648
US

IV. Provider business mailing address

733 MUIRLANDS VISTA WAY
LA JOLLA CA
92037-6202
US

V. Phone/Fax

Practice location:
  • Phone: 858-454-9341
  • Fax:
Mailing address:
  • Phone: 858-454-8575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG15132
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: