DR. JEFFREY LARS HAGEN (NPI# 1093792723) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093792723 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY LARS HAGEN |
| Credential | DPM |
| Practice Address |
5400 W Hillsdale Ave Visalia CA 93291-8222 |
| Practice Telephone | 5597387500 |
| Practice Fax Number | 5597342055 |
| Mailing Telephone | 5597387500 |
| Mailing Fax Number | 5597342055 |
| Enumeration Date | 2005-12-23 |
| Last Update Date | 2016-10-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | E4634 | CA | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
PO807 | WA | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
E4634 | CA | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GROUP NPI | 1366570772 | 01 |
| CA | 1366570772 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376997452 | Jeffrey Hagen | Counselor | 8302 Old York Rd, Suite #12, Elkins Park, PA 19027-1522 | 2016-04-14 |
| 1578609921 | Jeffrey Michael Hagen | Dentist | 6800 Montgomery Blvd Ne, Suite A, Albuquerque, NM 87109-1405 | 2007-01-30 |
| 1558391011 | Jeffrey Hagen | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1001 Blythe Blvd, Ste 300 - Thoracic Surgery, Charlotte, NC 28203-5866 | 2006-07-03 |
| Street Address |
5400 W HILLSDALE AVE |
| City | VISALIA |
| State | CA |
| Zip Code | 93291-8222 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164426961 | Shirley Pua | Internal Medicine | 5400 W Hillsdale Ave, Visalia, CA 93291 | 2005-06-09 |
| 1780293910 | Melanie Breanne Sanchez | Speech-Language Pathologist | 5400 W Hillsdale Ave, Visalia, CA 93291-8222 | 2020-07-23 |
| 1376164210 | Edgar Albino Botello | Nurse Practitioner | 5400 W Hillsdale Ave, Visalia, CA 93291-5140 | 2020-05-01 |
| 1831749159 | Abbey Morren | Nurse Practitioner | 5400 W Hillsdale Ave, Visalia, CA 93291-5140 | 2019-09-18 |
| 1972065076 | Denise Junio | Nurse Practitioner | 5400 W Hillsdale Ave, Visalia, CA 93291-8222 | 2019-04-05 |
| 1023594546 | Julieann Gonzales | Nurse Practitioner | 5400 W Hillsdale Ave, Visalia, CA 93291-8222 | 2018-07-17 |
| 1760927867 | Andrea G Van Beek | Nurse Practitioner | 5400 W Hillsdale Ave, Visalia, CA 93291-8222 | 2016-12-27 |
| 1366984825 | Jamie Lea Cox | Physician Assistant | 5400 W Hillsdale Ave, Visalia, CA 93291-5140 | 2016-11-14 |
| 1942658034 | Mina Raju Do Inc | Internal Medicine | 5400 W Hillsdale Ave, Visalia, CA 93291-8222 | 2016-05-30 |
| 1336515097 | Kaweah Delta Health Care Inc | Clinical Medical Laboratory | 5400 W Hillsdale Ave, Visalia, CA 93291-8222 | 2015-08-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255964854 | Stephanie Janae Ybarra | Orthotist | 5412 Avenida De Los Robles, Suite 101, Visalia, CA 93291 | 2020-02-21 |
| 1689223067 | Patricia Mari Marquez | Technician | 32481 Road 127, Visalia, CA 93291 | 2019-09-09 |
| 1942767710 | Jeremy Clifton Mccallister | Counselor | 120 W. School Ave., Visalia, CA 93291 | 2019-02-27 |
| 1568975290 | Kaweah Delta Health Care District | Clinic/Center | 3600 Flagstaff Avenue, Visalia, CA 93291 | 2017-11-16 |
| 1932625308 | Christina Gonzalez | Counselor | New Hope, 212 N. Stevenson, Visalia, CA 93291 | 2017-08-17 |
| 1629598545 | Estherose Molina | Assistant Behavior Analyst | 5445 W. Sweet Drive, Visalia, CA 93291 | 2017-06-21 |
| 1487195988 | Brenda Rodriguez | Case Manager/Care Coordinator | 546 East Tulare Ave, Visalia, CA 93291 | 2017-03-16 |
| 1295181857 | David James Tsuneji Fujihara | Emergency Medicine | 400 W. Mineral King Ave, Visalia, CA 93291 | 2016-05-12 |
| 1326409343 | Bay Area Surgical Specialists, Inc A Medical Corporation | Pain Medicine | 5127 W Noble Ave, Visalia, CA 93291 | 2016-03-18 |
| 1932585700 | Charles Dominick Trentacosti | Occupational Therapy Assistant | 514 N Bridge St, Visalia, CA 93291 | 2015-08-04 |
| Find all providers in zip 93291 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831281013 | Roger Alan Johnson | Podiatrist | 308 S Johnson, Visalia, CA 93291 | 2006-09-28 |
| 1093724429 | Loreen M Flaherty | Podiatrist | 2914 W Main St, Visalia, CA 93291-5731 | 2006-08-05 |
| 1962439158 | Michael E Flaherty | Podiatrist | 5405 W Hillsdale Ave, Visalia, CA 93291-5156 | 2006-06-26 |
| 1396745659 | Victor Kimball Grandt | Podiatrist | 4946 W Mineral King, Visalia, CA 93291 | 2005-07-28 |
| 1154888246 | Bay Area Surgical Specialists | Podiatrist | 2914 W Main St, Visalia, CA 93291-5731 | 2019-02-25 |
| 1699121814 | Michael Warcup | Podiatrist | 2914 W Main St, Visalia, CA 93291 | 2016-05-06 |
| 1346637576 | Ajay Ghai | Podiatrist | 5400 W Hillsdale Ave, Visalia, CA 93291-8222 | 2015-04-26 |
| 1083015580 | Terry Blake Nelson | Podiatrist | 2914 W Main St, Visalia, CA 93291 | 2014-09-16 |
| 1033554324 | Seth Jonah Brazier | Podiatrist | 116 N Akers St, Visalia, CA 93291-5121 | 2013-05-01 |
| 1750678652 | Derek James Florek | Podiatrist | 2914 W Main St, Visalia, CA 93291-5731 | 2011-06-30 |
| Find all providers in VISALIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.