Provider Demographics
NPI:1790020923
Name:JACQUELINE HAHN
Entity Type:Organization
Organization Name:JACQUELINE HAHN
Other - Org Name:HILO NATUROPATHIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAHN
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:808-969-7848
Mailing Address - Street 1:2980 N BEVERLY GLEN CIR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-1726
Mailing Address - Country:US
Mailing Address - Phone:310-474-9809
Mailing Address - Fax:
Practice Address - Street 1:142 KINOOLE ST
Practice Address - Street 2:SUITE B
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2838
Practice Address - Country:US
Practice Address - Phone:808-969-7848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JACQUELINE HAHN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-28
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site