Provider Demographics
NPI:1184756884
Name:HATCH, ILENE E (MD)
Entity type:Individual
Prefix:DR
First Name:ILENE
Middle Name:E
Last Name:HATCH
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Gender:F
Credentials:MD
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Mailing Address - Street 1:2192 MARTIN
Mailing Address - Street 2:SUITE 110
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-1428
Mailing Address - Country:US
Mailing Address - Phone:949-955-0072
Mailing Address - Fax:949-955-0077
Practice Address - Street 1:2192 MARTIN
Practice Address - Street 2:SUITE 110
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-1428
Practice Address - Country:US
Practice Address - Phone:949-955-0072
Practice Address - Fax:949-955-0077
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG071146207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG20691Medicare UPIN