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1396486320
THEODORE HAGENS
WEST HOLLYWOOD, CA
NPI
1396486320
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2085R0202X Radiology, Diagnostic Radiology
(Licence: MI 4351049044)
Enumeration Date
2022-04-05
Last Update Date
2023-06-23
Business Address
THEODORE HAGENS MD
8700 BEVERLY BLVD # M335
WEST HOLLYWOOD, CA 90048-1804
Phone number: 310-423-3095
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Mailing Address
THEODORE HAGENS MD
200 JEFFERSON AVE SE
GRAND RAPIDS, MI 49503-4502
Phone number: 616-685-6867
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