Provider Demographics
NPI:1578744074
Name:JOHN M. HASSLER, M.D., INC
Entity Type:Organization
Organization Name:JOHN M. HASSLER, M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:HASSLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-454-9341
Mailing Address - Street 1:1223 ROSLYN LN
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-3648
Mailing Address - Country:US
Mailing Address - Phone:858-454-9341
Mailing Address - Fax:
Practice Address - Street 1:1223 ROSLYN LN
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-3648
Practice Address - Country:US
Practice Address - Phone:858-454-9341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-26
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG15132102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG15132Medicare PIN