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NPI Code Detail

MEDICARE: DR. RYAN JAMES HAGENS MD

MEDICARE: DR. RYAN JAMES HAGENS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12081P2900XPain Medicine (Physical Medicine & Rehabilitation) PhysicianA177052CA
22081P2900XPain Medicine (Physical Medicine & Rehabilitation) PhysicianCDR.0004799CO

General Provider Information

NPI Number : 1073008991
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RYAN JAMES HAGENS MD
Provider Business Mailing Address
First Line : 930 SOMERSBY WAY
Second Line :
City : SACRAMENTO
State : CA
Zip : 95864-6132
Country : US
Telephone Number : 530-417-4852
Fax Number :
Provider Business Practice Location Address
First Line : 3330 S RIO GRANDE AVE
Second Line :
City : MONTROSE
State : CO
Zip : 81401-4847
Country : US
Telephone Number : 970-252-2584
Fax Number : 970-252-2594
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2018
Last Update Date : 03/18/2025

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Directions to “ DR. RYAN JAMES HAGENS MD” Practice Location

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