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General NPI Number Information
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NPI Number | 1356353361
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Entity Type | Organization
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Legal Business Name | MOWBRAY P. HAGAN, M.D. INC.
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Dates
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Enumeration Date | 08/12/2006
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 760 WASHBURN AVE STE 4
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City | CORONA
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State | CA
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Zip | 92882-3303
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Country | US
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Telephone | 951-734-6110
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Fax | 951-734-9989
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Provider Business Mailing Address
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Address Line | 760 WASHBURN AVE STE 4
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City | CORONA
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State | CA
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Zip | 92882-3303
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Country | US
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Telephone | 951-734-6110
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Fax | 951-734-9989
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MOWBRAY P. HAGAN
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Credential | M.D.
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Telephone | 951-734-6110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | A29431
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License Number State | CA
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