Provider Demographics
NPI:1376791053
Name:HAHN, DAVID MICHAEL (LAC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:MICHAEL
Last Name:HAHN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4827 COLLWOOD BLVD UNIT B
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92115-2173
Mailing Address - Country:US
Mailing Address - Phone:619-892-1611
Mailing Address - Fax:
Practice Address - Street 1:1530 JAMACHA RD
Practice Address - Street 2:B1
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92019-3700
Practice Address - Country:US
Practice Address - Phone:619-444-3477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-05
Last Update Date:2008-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12273171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist