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General NPI Number Information
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NPI Number | 1073008991
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Entity Type | Individual
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Provider Name | RYAN JAMES HAGENS MD
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Gender | Male
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Dates
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Enumeration Date | 06/22/2018
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 3330 S RIO GRANDE AVE
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City | MONTROSE
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State | CO
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Zip | 81401-4847
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Country | US
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Telephone | 970-252-2584
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Fax | 970-252-2594
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Provider Business Mailing Address
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Address Line | 930 SOMERSBY WAY
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City | SACRAMENTO
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State | CA
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Zip | 95864-6132
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Country | US
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Telephone | 530-417-4852
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | A177052
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | CDR.0004799
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License Number State | CO
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