Provider Demographics
NPI:1790934743
Name:HAIR, JAMES
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:HAIR
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 1:3800 E. PACIFIC COAST HWY.
Mailing Address - Street 2:#2
Mailing Address - City:CORONA DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92625
Mailing Address - Country:US
Mailing Address - Phone:949-675-1146
Mailing Address - Fax:949-675-3741
Practice Address - Street 1:3800 E. PACIFIC COAST HWY.
Practice Address - Street 2:#2
Practice Address - City:CORONA DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92625
Practice Address - Country:US
Practice Address - Phone:949-675-1146
Practice Address - Fax:949-675-3741
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-15
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADJ033933122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice