Healthcare Provider Details

I. General information

NPI: 1508927997
Provider Name (Legal Business Name): RICHARD J HAHN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 11/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44215 15TH ST W SUITE 203
LANCASTER CA
93534-4014
US

IV. Provider business mailing address

44215 15TH ST W SUITE 203
LANCASTER CA
93534-4014
US

V. Phone/Fax

Practice location:
  • Phone: 661-948-0062
  • Fax: 661-949-5787
Mailing address:
  • Phone: 661-948-0062
  • Fax: 661-949-5787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberG25115
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: