Provider Demographics
NPI:1669020699
Name:HAHN, JAMES
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:HAHN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1643 W ALPS DR
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91784-2511
Mailing Address - Country:US
Mailing Address - Phone:909-243-4363
Mailing Address - Fax:
Practice Address - Street 1:750 W ROUTE 66 STE N
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-4164
Practice Address - Country:US
Practice Address - Phone:626-335-8749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-03
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA297313225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist