Basic Information
| Provider Information | |||||||||
| NPI: | 1194764738 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HA | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | H | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1412 BLUE OAKS BLVD | ||||||||
| Address2: | |||||||||
| City: | ROSEVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 957477143 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9167847546 | ||||||||
| FaxNumber: | 9167847548 | ||||||||
| Practice Location | |||||||||
| Address1: | 1412 BLUE OAKS BLVD | ||||||||
| Address2: | |||||||||
| City: | ROSEVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 957477143 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9167847546 | ||||||||
| FaxNumber: | 9167847548 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2006 | ||||||||
| LastUpdateDate: | 01/10/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | A60428 | CA | Y | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.