Healthcare Provider Details

I. General information

NPI: 1831027762
Provider Name (Legal Business Name): ANDREW M HAHN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 W TOWN AND COUNTRY RD STE 1225
ORANGE CA
92868-4638
US

IV. Provider business mailing address

6410 HOMEWOOD AVE
BUENA PARK CA
90621-2955
US

V. Phone/Fax

Practice location:
  • Phone: 714-542-2400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: