Provider Demographics
NPI:1124059894
Name:RICHARD J. HAHN, M.D., A MEDICAL CORP
Entity type:Organization
Organization Name:RICHARD J. HAHN, M.D., A MEDICAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:HAHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-948-0062
Mailing Address - Street 1:44215 15TH ST W
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-4014
Mailing Address - Country:US
Mailing Address - Phone:661-948-0062
Mailing Address - Fax:661-949-5876
Practice Address - Street 1:44215 15TH ST W
Practice Address - Street 2:SUITE 203
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-4014
Practice Address - Country:US
Practice Address - Phone:661-948-0062
Practice Address - Fax:661-949-5876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG25115208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G251150Medicaid
CAG25115Medicare ID - Type Unspecified
CA00G251150Medicaid