Provider Demographics
NPI:1578282968
Name:HAGUE, CURTIS WILLIAM (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:WILLIAM
Last Name:HAGUE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11230 DONNER PASS RD
Mailing Address - Street 2:
Mailing Address - City:TRUCKEE
Mailing Address - State:CA
Mailing Address - Zip Code:96161-4808
Mailing Address - Country:US
Mailing Address - Phone:530-587-5296
Mailing Address - Fax:
Practice Address - Street 1:11230 DONNER PASS RD
Practice Address - Street 2:
Practice Address - City:TRUCKEE
Practice Address - State:CA
Practice Address - Zip Code:96161-4808
Practice Address - Country:US
Practice Address - Phone:530-587-5296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58152183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
224156OtherNABP