Provider Demographics
NPI:1164717229
Name:O'HAGAN, JOHN (MA)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:O'HAGAN
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1808 FULTON ST
Mailing Address - Street 2:APT 10
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117
Mailing Address - Country:US
Mailing Address - Phone:360-489-4667
Mailing Address - Fax:
Practice Address - Street 1:1808 FULTON ST
Practice Address - Street 2:APT 10
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-1243
Practice Address - Country:US
Practice Address - Phone:360-489-4667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-16
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program