Provider Demographics
NPI:1982646832
Name:HAGE, JEAN-CLAUDE (MD)
Entity Type:Individual
Prefix:DR
First Name:JEAN-CLAUDE
Middle Name:
Last Name:HAGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1690 BARTON RD STE 106
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-4230
Mailing Address - Country:US
Mailing Address - Phone:909-886-4917
Mailing Address - Fax:909-886-0699
Practice Address - Street 1:1690 BARTON RD STE 106
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-4230
Practice Address - Country:US
Practice Address - Phone:909-886-4917
Practice Address - Fax:909-886-0699
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG77308207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G01483Medicare UPIN