Provider Demographics
NPI:1407880073
Name:HAHN, HYOJOON PHILLIP (MD)
Entity Type:Individual
Prefix:
First Name:HYOJOON
Middle Name:PHILLIP
Last Name:HAHN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:PHILLIP
Other - Middle Name:
Other - Last Name:HAHN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 5667
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92863-5667
Mailing Address - Country:US
Mailing Address - Phone:888-598-8820
Mailing Address - Fax:714-571-5055
Practice Address - Street 1:11620 WILSHIRE BLVD
Practice Address - Street 2:STE. 100
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-1706
Practice Address - Country:US
Practice Address - Phone:310-914-7336
Practice Address - Fax:310-914-7326
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG603532085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G603530OtherBLUE SHIELD
CA00G603530Medicaid
CAWG60353UMedicare ID - Type Unspecified
CA00G603531Medicare ID - Type Unspecified
CAWG60353AAMedicare ID - Type Unspecified
CA00G603533Medicare ID - Type Unspecified
CAWG60353Medicare ID - Type Unspecified
CAWG60353SMedicare ID - Type Unspecified
CAWG60353WMedicare ID - Type Unspecified
CA00G603530Medicaid
CA00G603530OtherBLUE SHIELD
CAA64368Medicare UPIN
CAWG60353XMedicare ID - Type Unspecified
CAWG60353VMedicare ID - Type Unspecified
CA00G603532Medicare ID - Type Unspecified
WG60353EEMedicare PIN
CAWG60353ZMedicare ID - Type Unspecified
S051568Medicare PIN
WG60353TMedicare PIN